Transcript Slide 1

Before leaving for
the day, you’ll…
know more about schoolchildren’s
nutritional needs
understand the nutritional
requirements for school lunch /
snacks guidelines
learn to make use of the
‘NutriAgent’ Handbook
understand how to use the monitor
/ assessment forms to keep check
on the nutritional standard of
school lunch / snacks
Stormy and perilous
Completely exposed to
drawbacks from all sides
Countless difficulties and
barricades
Strength-exhausting and
brain-racking
‘You’-oriented
Cross-sector synergistic
cooperation
Continual support
Appreciation and reward
Assessment and review
Leaving a lasting
reputation
Health and Nutrition
Nutritional Guidelines on School Lunch for
Primary Students and compliance monitor
Nutritional Guidelines on Snacks for Primary
Students and compliance monitor
Organising projects promoting healthy eating at
school
Support, record and reward
Q&A sharing
• The 3 major factors below count 60% on the
death toll* in Hong Kong:
– Cancer (33%)
– Heart diseases (16.3%)
– Cerebrovascular diseases (10.5%)
• Unhealthy dietary habits
increase the risk of chronic illnesses
cause overweight and obesity
*Data of 2005 *
• The percentage of primary schoolchildren
with obesity*
25.0%
• rose from 16.4%
in 1997/98
• to 19.4% in
2005/06
20.0%
15.0%
男生
女生
10.0%
總計
5.0%
0.0%
97/98 98/99 99/00 00/01 01/02 02/03 03/04 04/05 05/06
Boys
* Data Source: DH Student Health Service
Girls
Total
Obesity refers to the excessive storage of fat
in the body, which may cause health
impairment
Energy
Output
Energy
Input
Children
– Growth Charts
e.g. : Weight-for-Height Chart
Healthy eating habits built up in childhood are
more likely to be carried on into adulthood
Schoolchildren generally fail to follow healthy
eating principles
Studies abroad pointed out that school-based
intervention programmes are found with proven
effectiveness in promoting healthy dietary habits
among schoolchildren
leg in Pure orange
Yoghurt Wheat bread Chicken
Chinese ‘Lo
juice
with raisin
Shui’ sauce
Healthier
More
unhealthy
95.6%
95.9%
95.0%
97.7%
4.4%
4.1%
5.0%
2.3%
Ice cream
Hot dog
Deep-fried
chicken leg
Soft drink
leg in Pure orange
Yoghurt Wheat bread Chicken
Chinese ‘Lo
juice
with raisin
Shui’ sauce
Healthier
48.1%
49.1%
More
unhealthy
51.9%
50.9%
Ice cream
Hot dog
65.2%
64.9%
34.8%
35.1%
Deep-fried
chicken leg
Soft drink
Recipes
without ‘less
healthy
ingredients’
36.8%
Recipes with
‘less healthy
ingredients’
63.2%
Items sold
at tuck
shops
‘Snacks to
choose more’
‘Snacks to
choose in
moderation’
‘Snacks to
choose less’
14.6%
29.7%
Items sold
in vending
machines
10.0%
Items
brought
to school
from home
13.1%
28.8%
51.3%
55.7%
61.3%
35.6%
dietary habits and health are closely related
the existence of substantial gap between
students’ knowledge and practice of healthy
eating
teachers and parents have to be role models
To work together with us and give our next
generation a healthy eating environment!
School ‘NutriAgent’ Project
Nutritional Training Workshop
Techniques of surveillance &
negotiation
In this session, you’ll:
 Understand how to undertake surveillance of the
school eating environment
 Know more about schoolchildren’s nutritional needs
 Understand the qualitative and quantitative
requirements in the Nutritional Guidelines on
School Lunch / Snacks for Primary School
Students
 Learn to answer some FAQs about diet
 Know how to use surveillance forms to keep the
nutritional standard of school lunch / snacks in
check
How to undertake
surveillance of the school
eating environment?
What is Surveillance?
 Data Collection
 Data Collation
 Data Analysis
 Dissemination
 Actions for Improvement
What we need for
surveillance at school:
 Basic knowledge of nutrition
 Simple tools for lunch / snack
surveillance
 Items to be negotiated with lunch
suppliers or tuck shop operators
School Lunch
Surveillance
Nutritional Guidelines on
School Lunch for Primary
School Students
With the guidelines,
we hope to…
 Achieve energy balance
 Increase intake of fruit
& vegetables
 Reduce total intake of
fat, sugar and salt
in students’ diet
About the guidelines:
(1) Guidelines on Quantity
(2) Guidelines on Quality
(1) Guidelines on
Quantity
How much should a
schoolchild eat?
??
Food
Pyramid for
Children
A healthy lunch should…
provide schoolchildren with
one third of the nutrients
they need every day
Tips on healthy lunch
box
Grains & cereals, vegetables and meat
should be in the ratio of 3 ： 2 ： 1 by
volume
Recommended Quantity of
Lunch for Junior and Senior
Primary School Students
Food Group
Grains & Cereals
Vegetables
P.1 – P.3 Students
P.4 – P.6 Students
At least 4 servings At least 5 servings
At least 1 serving
At least 1 serving
Meat, Poultry, Fish,
1-2 servings
1½ - 2½ servings
Eggs, Legumes
Fruit
At least ½ serving At least ½ serving
Fats and Oil
Max. 2 servings
Max. 2 servings
What is ‘serving’?
 unit of recommended serving size
 helps maintain a balanced diet
 used for describing the recommended
quantity of food needed daily from
the 5 food groups
One serving =
Grains &
cereals
 ~1/5 bowl
Vegetables Meat, Legumes,
Eggs
 1 bowl of raw  4 slides of cooked
 ~1/4 bowl of
noodles
 ~1/3 bowl
1/2 bowl of
cooked
 1/2 bowl of cooked
 1/3 bowl
 ~1/2 slice of bread
1
~ 1
an egg
as big as
One serving =
Fruit
Fats and Oils
 1 medium-sized (as big as a fist)
 1 tsp of plant oil
 1/2
 1 tbsp of salad
dressing
 1 handful (about 10 grapes)
 1 glass (150ml)
 1/2 box of unsweetened dried fruit
(2) Guidelines On
Quality
How to choose ‘quality’
healthy lunch for children?
Quality Food
 3 lows, 1 high:
Low-fat, low-sugar, low-salt and
high-fibre
 Types of food in lunch:
 Encouraged food items
 Limited food items
 Strongly discouraged food
items
Encouraged Food Items
 Natural and fresh
 ‘3 lows, 1 high’ food
Encouraged Food Items
 Whole-wheat or high-fibre grains &
cereals
 Low-fat dairy products or other
calcium-rich food
Limited Food Items
 Processed / preserved food or food
with added oil, salt or sugar
 High-salt or high-fat sauce and gravy
≤ 2 days/week
Limited Food Items
 Grains and cereals with added fat or oil
e.g. fried rice, fried noodles, fried rice noodles,
baked rice with excess sauce
*Remark: It is recommended that sauce or gravy with high salt or fat content should
be served sparingly and separately.
Limited Food Items
 Fatty cut of meat and
poultry with skin
e.g. chicken wings, spare ribs,
chicken legs, ox belly, fatty
minced meat cake
 Whole-fat dairy products
e.g. full-cream milk, regular
cheese, full-cream yoghurt
Limited Food Items
 Processed or preserved meat, eggs
and vegetables
e.g. sausages, ham, BBQ pork, preserved
mustard green
Strongly Discouraged
Food Items
 Food very high in fat, salt or sugar
 Food with added animal fat, plant
saturated fat and trans fat
Say
NO!
Strongly Discouraged
Food Items
 Deep-fried
food
French fries
Deep-fried
fish fillet
Deep-fried
Tofu
Deep-fried
chicken leg
Strongly Discouraged
Food Items
 Food with added animal fat,
plant-based saturated fat and
hydrogenated fat
e.g. lard, chicken oil, butter, coconut oil,
palm oil, margarine
Strongly Discouraged
Food Items
 Desserts or beverages containing more
than 10 grams or 2 tsp of added sugar in
each serving
Strongly Discouraged
Food Items
 Very salty food
e.g. preserved meat sausages, salted
fish, salted eggs, etc.
FAQs on Children’s
Diet
FAQs on Children’s Diet
Is potato vegetable?
No, it belongs to the Grains & Cereals
group.
Other plant foods in the grains and
cereals group include corn, taro, sweet
potato and carrot, yet they are also
counted as vegetables.
Pumpkin is in the ‘Vegetables’ group only.
FAQs on Children’s Diet
How many calories should be
provided in children’s lunch？
About 650kcal
FAQs on Children’s Diet
Is the quantity in lunch for junior primary
students same as that for senior ones？
No. As the daily nutritional needs of these 2
groups are not the same, their demand for
grains & cereals and meat are also different.
Please refer to ‘Nutritional Guidelines on Lunch
for Primary Students’ for more information.
As for the recommended amount of vegetables
and fruit, it is generally the same for all
students.
FAQs on Children’s Diet
Is margarine healthier than butter that
we can feel free to use more for cooking?
No. It’s because margarine contains trans fat
which will also adversely affect our blood
cholesterol level and increase the risk of
cardiovascular diseases or stroke. Moreover,
margarine has the same calorie content as
butter, which may also lead to obesity if
consumed excessively.
Tools for Lunch
Surveillance in Primary
Schools
Nutritional Quality Evaluation
Form of School Lunch
For whom to use?
When to use?
 Assign two teachers or parents
 Once a month
 Choose a week with 5 consecutive
school days to be the assessment
week
What you need:
(1) Grouping list of
food items for lunch
(2) Nutritional Quality
Evaluation Form of School
Lunch
(3) Lunches of the
week
１
２
5
３
４
How to observe changes in
food quality?
Provision of vegetables in lunch
100
80
%
60
40
20
0
Sept
2006
Oct
2006
Nov
2006
Dec
2006
Jan
2007
Feb
2007
Mar
2007
Apr
2007
May
2007
June
2007
July
2007
E.g. Low-fat Curry Chicken
with Vegetable Red Rice
23/9
Low-fat Curry Chicken with
Vegetable Red Rice





362
Action Time!
Activity 1
Dissemination of
Surveillance Results
School Executives,
Headmasters / Teachers
Students
Lunch
Suppliers
Parents
Negotiation with school lunch
suppliers
 School and PTA may take the surveillance
results as an item for negotiation
 Should the surveillance results show the
followings:
•
fruit supply %
•
vegetable supply %
•
Encouraged Food Items %
•
Limited or Strongly Discouraged Food Items %
communication with suppliers have to be
promptly initiated for improvement.
Things to remind…
• Always be positive
• Gather and select comments or suggestions
in advance
• Realize that meat is not the main part of
lunch, but grains and vegetables are
• Tasty = full-flavored / salty
• Nutritional value should always be the top
priority when choosing a lunch supplier
Take Home Messages
(on lunch)
 Grains and cereals, vegetables and
meat = 3 : 2 : 1
 ‘3 Lows, 1 High’ should be the rule
for food
 Cook with less oil
3 2 1 Healthy Lunch
Suitable for Everyone
Let’s Take a Break!!!
School Snack
Surveillance
Nutritional Guidelines on
Snacks for Primary School
Students
What is Snack?
‘Snack’ means an amount of food
smaller than a meal eaten informally
between meals.
Is snack a must?
 Snack is not main meal
 Just children eat adequately in a balanced
way and don’t feel hungry between main
meals
Snack is not a must!
Snack is appropriate if
children:
 feel hungry between main meals;
 eat snacks at the right time; and
 eat in small amount which does not
affect the appetite for the main meals
Parents may consider giving them some
healthy snacks!
But in many cases…
Children might feel hungry between meals because
of:
 Small stomach, small capacity
 High energy output
 Imbalanced diet in the day
So we can have
some snacks if that
doesn’t affect our
appetite for the
main meals!
The right time for snacks…
There should be at least
1.5 – 2 hours
between snacks and main meals
to avoid spoiling children’s appetite for the
next meal.
Appropriate serving size
for snacks…
It is usually smaller than that for a main
meal, and it does not mean to replace
the main one.
e.g. :
 1 slice of wheat bread +
1 glass of low-fat milk
 1 apple + 1 glass of
water
 2-3 plain biscuits + 1
glass of pure fruit juice
How to choose healthy
snacks?
 Snacks to Choose More
 Snacks to Choose in Moderation
 Snacks to Choose Less
Snacks to Choose More
Criteria for selection:
Containing at least one type of
nutrients (e.g. dietary fibre,
protein, calcium), and
Low in fat
Low in sugar
Low in salt
High in fibre
‘3 Lows, 1 High’ Principle
Snacks to Choose More
Bread and grains and cereals that are low in fat,
salt & sugar
Snacks to Choose More
Fresh vegetables and fruit, and
unsweetened dried fruit
Snacks to Choose More
Low-fat dairy products
Low-fat
yoghurt
Low-fat
milk
Snacks to Choose in
Moderation
containing at least one type of
nutrients (e.g. calcium and dietary
fibre)
but also containing fat and added
sugar or salt
Snacks to Choose in
Moderation
 Bread and cereals with
added fat, sugar or
salt
 Processed and
preserved vegetables
Snacks to Choose in
Moderation
 Fruit with added
sugar
 Whole-fat dairy
products
Snacks to Choose in
Moderation
 Fatty, processed or preserved meat and
its alternatives
 Beverages with added sugar but also
contain nutritional value
Snacks to Choose Less
Food or beverages low in nutritional
value but high in fat, sugar and salt
Frequent consumption of these snacks
may increase the risk of:
•
•
•
•
Obesity
Heart diseases
Diabetes
High blood pressure
Snacks to Choose Less
Snacks high in fat, sugar and salt
Beverages
Choose More Water
Pure fruit juice
Low-fat milk
Choose in
Moderation
Sweetened fruit juice
Sweetened soya milk, whole-fat
milk, chocolate milk
Choose Less Soft drink, sweetened cartoned
drink, cordials, black tea, coffee
Food Label Reading
Source of Information: Food and Environmental Hygiene Department
What can food labels do?
Help consumers:
 better understand the nutritional value of
food
 compare similar food products
 make healthier food choices or select
suitable food for disease management
Food labels can encourage food manufacturers
to:
 improve nutritional content of products
Content of food labels
Food labels
Nutrition labelling
Claims
Nutrition claims Function claims
Health claims
Nutrient
content claim
Nutrient
comparative
claim
Types of
nutrition labels
Types of nutrition labels
How to read nutrition
labels?
Step 1: Find out the serving size
How many servings are there in 1 pack of
Udon?
4 servings
How many grams are there in 1 serving of
Udon?
200 grams
Udon
How to use nutrition
labels?
Step 2: Check out the calorie content
How many calories are there in 1
serving of Udon?
320kcal
How many calories are there in 1 pack
of Udon?
1280kcal
How to use nutrition
labels?
Step 3: Look for the nutritional value
What is the unit of nutritional Per Serving
content?
How to compare the
nutritional value of food?
‘Per Serving’
 The amount of
nutrient you
consume
‘Per 100g’
 For compare the
nutritional values
of different food
items using 100g
as a unit
Which one is better?
Milk A 
Calories
Calcium
Protein
Dietary fibre
Milk B
FAQs on children’s
diet
FAQs on children’s diet
There are many beverages on the
market coming with health claims. Can
these claims be trusted?
Not all beverages with
health claims are
healthy. Parents may
refer to the ingredient
list on the package to
see where ‘sugar’ is put.
FAQs on children’s diet
Is it right for children to skip
breakfast to avoid over-eating if they
eat snacks during recesses?
No.
Breakfast is one of the main meals. It should
not be skipped and should be eaten at regular
time. It should mainly consist of grains and
cereals (e.g. bread, congee or oatmeal).
Skipping breakfast may lead to over-eating at
recesses or lunch.
FAQs on children’s diet
Children love choosing fried and
deep-fried snacks. How can we
help them to get rid of these food?
We can first reduce children’s weekly
frequency of intake. Then gradually, we can
use some fresh food such as vegetables or
fruit to replace them.
FAQs on children’s diet
Would low-fat dairy products like milk,
yoghurt or cheese be less nutritive than
full-fat ones?
No. All dairy food is rich in calcium, which is
good for teeth and bone growth. In fact, the
nutritional content of low-fat dairy products
are similar to those of the full-fat ones,
especially in terms of protein and calcium. In
addition, low-fat dairy products are lower in
calories and fat, thus benefit our body more.
FAQs on children’s diet
Can sports drinks be provided for
children instead of water?
Sports drinks or electrolyte-charging
drinks are specially designed for
athletes. Children should not take
sports drinks for water to replenish
water loss during study or exercise.
Rather, plain water is the best refill.
Tools for Snack
Surveillance
School Snacks
Monitoring
Checklist
For whom to use?
When to use?
 assign two teachers or parents
 use monthly
What you need:
(1) Snack categorising list
(2) School Snacks
Monitoring Checklist
(3) A list of snacks and beverages supplied at school
tuck shop and/or vending machines
１
２
３
４
How to observe changes
in snack quality
Snack Supply Trendlines
60
Snacks to Choose More
50
%
40
Snacks to Choose in Moderation
30
20
10
Snacks to Choose Less
0
Oct-06
Nov-06
Dec-06
Snacks to Choose More (%)
Jan-07
Feb-07
Mar-07
Apr-07
Snacks to Choose in Moderation (%)
May-07
Jun-07
Jul-07
Snacks to Choose Less (%)
Let’s group them up
French fries
Raisin puff
Cookies
Boiled corn
Choose Less
Choose in Moderation
Choose less
Choose more
Bean curd dessert
Choose in moderation
/ Choose more
Chocolate milk
Choose in moderation
Orange-flavoured
drink
Choose less
Action Time!
Activity 2
Dissemination of
Surveillance Results
School Executives,
Headmasters / Teachers
Students
Tuck shop
operators
Parents
Negotiation with tuck shop
operator
 School and PTA may take the surveillance
results as an item for negotiation
 Should the surveillance results show the
followings:
•
‘Snacks to Choose More’ %
•
‘Snacks to Choose in Moderation’ & ‘Snacks
to Choose Less’ %
communication with operators have to be
promptly initiated for improvement.
Things to remind…
• Always be positive
• Both ‘Snacks to Choose More’ & ‘Snacks
to Choose in Moderation’ can be sold at
school tuck shop
• Small, individual servings of snacks can be
offered
• Avoid using food as reward
• Encourage students not to bring ‘Snacks to
Choose Less’ back to school so as to build
up a healthy eating environment
Ways to encourage
children to eat more
healthy food
Way 1:
Make salad with colourful fruit and
vegetables, eggs and little low-fat salad
dressing to attract children. This could be a
dessert after meal or tea refreshment.
Way 2:
Parents may go shopping with children and buy
their favourite fruit. Children are
encouraged to take part in the preparation,
so as to increase their interest in eating
fruit and vegetables.
Way 3: Food substitution
Potato chips
Luncheon meat
and ham sandwich
Cornflakes or fruit
chips
Wholewheat bread with
fresh tomato & boiled egg
Full-fat dairy
products
Low-fat dairy
products
French fries
Baked mashed potato /
Baked potato wedges
Deep-fried chicken
leg and wing
Baked chicken leg or
breast (skinned)
Way 4:
Try mixing food that children
have never tried or dislike
with those they like. Start
with a small amount and
gradually increase the portion.
Take Home Messages
(on snacks)
1. Snacks could not replace
main meals
2. Better to have a time lag of
1.5-2 hours between snacks
and main meal
3. Choose ‘3 Lows, 1 High’
Snacks
‘1 High, 3 Lows’ Snacks
Healthy and Tasty
• To provide teaching resources and templates
for reference
• To assist teachers and parents in running
healthy eating activities
• To simplify the procedure of organising
activities for saving teachers’ and parents’ time
1. How to formulate ‘School Healthy Eating Policy’?
2. Undertaking surveillance of school eating
environment (lunch and snacks)
3. Methods of planning and procedures of running
activities
4. Proposals on projects / programmes promoting
healthy eating
5. Support, record and reward
We have developed 26 proposals of promotional
activity in TWO categories:
1. Policy, surveillance, environment and behaviour
2. Knowledge, attitude and awareness
Policy, surveillance, environment and behaviour
(1)
(2)
(3)
(4)
Formulating healthy eating policy
Healthy eating surveillance in action – lunch
Healthy eating surveillance in action – snacks
DIY surveys of healthy eating environment and students’
dietary habits
(5) Work together to promote lunch guideline policy
(6) Tuck shop of health and nutrition
(7) Red-yellow-green snacks zoning system
(8) Give tuck shop a new face
(9) Teacher-Student Fruit Day
(10) ‘Choose the Smart and Healthy Lunch’ Campaign
(11) Lunchtime broadcast on nutritional analysis of meal
(12) A Lunchtime for Parents and Students
Knowledge, Attitude and Awareness
(13) Visit to kitchens of school lunch suppliers
(14)
(15)
(16)
(17)
(18)
(19)
(20)
(21)
(22)
(23)
(24)
(25)
(26)
Parent-child Snacks Campaign
Healthy Eating Ambassadors
Healthy Eating Carnival
Healthy Eating Garden
Healthy Eating Quiz
Publishing in-school healthy eating quarterly by students
Healthy eating API making competition
Healthy Eating poster design competition
Healthy Eating story competition
Model making competition of Healthy food teaching aid
Healthy lunch / snacks comic strip competition
Healthy Snacks Catwalk Show
Healthy gourmet’s dish paper plate drawing competition
School ‘NutriAgent’ Project Requirements
** No less than two activities are to be conducted for the
academic year 2006-2007
• Specially recommended activities
(2) Healthy eating surveillance in action -- Lunch
(3) Healthy eating surveillance in action -- Snacks
• Optional activities
Activities suggested in the Handbook and other schoolbased activities designed for healthy eating promotion
Professional advice
– Through our enquiry hotline, our
professional team provide
consultancy on:
• the process of organising events
• problem solving
• resources available
• recommendation of community
resources
• the progress follow-up of the
programme organisation for the
year
Resources available
– Health education
resources
– Community
resources
Volunteers’ support
Appreciation
Record and Reward
Appreciation and commendation to the
‘NutriAgents’ who are cordially devoted to
proactive running of events promoting
healthy eating in school
• Proposals
• Evaluation Reports
Evaluation Reports
• Photographs, promotion posters,
questionnaires and results of evaluation study
• By post, fax or e-mail to DH
• For events lasting longer than 8 weeks, an
interim report is to be submitted, followed by
the final report upon the completion of event.
• Judging criteria
– Nature of event
(Policy / Environment, continual surveillance, knowledge /
concern)
– Scale of event
(Number of participating parents / students / members of
the community)
– Duration
– Participation of volunteers
– Evaluation of effectiveness
• Record of the event’s scoring
– NutriSchool Record
– NutriAgent Record
•
•
•
•
Infinity
Childhood obesity
Chronic illnesses
Enjoy
of satisfaction
no more
morbidity declines
life