Is Nutrition Education Really Failing?

July 17, 2007

by Jean Saunders, HSC School Wellness Director

The news wires buzzed last week after an AP review of research was published around the country in articles such as “Nutrition education efforts failing” in the Chicago Tribune.

The assertion that nutrition education is not effective was based on the review of 57 scientific studies of such education programs, four of which showed positive results or effectiveness in changing behavior.

“Any person looking at the published literature about these programs would have to conclude that they are generally not working,” said Dr. Tom Baranowski, a pediatrics professor who studies behavioral nutrition at Houston’s Baylor College of Medicine.

Baranowski’s research is directed toward understanding why children eat the foods they eat and engage in the physical activities they do. He is also working on designing and evaluating programs to help change these dietary and physical activity behaviors.

If a leading contributor to the field of pediatrics research asserts that the programs are not working, should we abandon the considerable efforts underway to provide nutrition education to school-aged children?

Before we do that, let’s see if we can learn something from other important aspects of Baranowski’s work.

In an effort to understand why programs to increase physical activity among children have varied levels of success, Dr. Baranowski has been examining the factors that come between the physical activity programs and the desired results.

He describes these factors as the moderating and mediating variables—the external factors that affect how well programs work. These include gender differences, for example, as well as family support and the availability of space or equipment for physical activity.  No matter how great an education program to increase physical activity is, it’s unlikely to yield long-term results if children don’t have time or space to be active outside of the program.

The results of these investigations have led Baranowski to develop a model showing how outside influences play a role in the success of program.  With this model, Baranowski has begun to design programs to change the mediating variables – that is, to change the outside influences as well as the education programs.

“It’s the changes in mediating variables that lead to behavior change,” Dr. Baranowski explains.

Like Dr. Baranowski, I would like to know about the “mediating variables” in those four nutrition education programs that were successful.

Why were those interventions successful? It’s likely that the “mediating variables” in the successful studies included the school food environment, opportunities for physical activity, and support from teachers and parents. With the right factors in place, nutrition education yields positive results.

The Tribune article includes the statement that few nutrition education programs hold “promise as weapons against childhood obesity.”

Dr. Baranowski’s work affirms that programs do not offer a simple answer or a silver bullet to reverse the disturbing growth in childhood obesity.

Offering nutrition education without changing the factors that affect children’s food choices – such as improved school food or the availability of fresh fruit as snacks – is unlikely to yield stellar results. When education is accompanied by appropriate changes in the environment, though, children are more likely to make healthy choices.

With an integrated approach that accounts for the factors surrounding education programs, we can make a real difference in children’s health behavior