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Educated Choices

Children discover the healthiest foods through the incentive of an educational game

During a complete academic year, children between the ages of 7 and 10 years, studying at municipal schools in the São Paulo district of Vila Mariana, were exposed to educational exercises, through the use of games and a children’s story tale, so as to learn how to correctly feed themselves and thus prevent illnesses in their adult lives. “In the end, we observed small changes, which were however consistent”, evaluates the research coordinator, professor José Augusto Carrazedo Taddei, from the Pediatric Department of the Federal University of Sao Paulo (Unifesp).

“There was a decrease in the consumption of delicacies, a small increase in physical activity and a reduction in obesity”, he stated. One of the first concrete results of the study is an educational game named Prato Feito (Dish of the Day), forecast to be launched commercially at the end of the year by the company Pais&Filhos, from the town of Aparecida do Taboado, in the State of Mato Grosso do Sul.

The dispute to reach the end of the board involves forty cards and questions. In one of them the child has as his/her task the choosing of a better option to substitute the evening meal with a snack. Among the alternatives found are: coffee with milk and bread with margarine; fruit juice and a chicken breast sandwich; popcorn and a diet soft drink and two pieces of seasoned sausage pizza. In another question, the correct response suggests milk should be drunk three times per day, on average, in order to grow with “strong healthy bones”.

Without anemia
Also there is no lack of questions concerning which is the food which improves iron intake in meals or what are the symptoms that a child with anemia might show. “For the game’s first edition, 3,000 units will be manufactured, of which 150 will remain with Unifesp, which has been entrusted with distributing them freely to institutions interested in the educational character of Prato Feito”, says Fabrício Lalucci Pereira de Souza, the manufacturing company’s director.

The idea of creating a commercial game came about as a consequence of the results obtained with the research, carried out on around 2,500 primary school children in the city school network. The project, funded by FAPESP, covered eight schools, all within the same district, in order to facilitate the movement of the researchers. Random choice defined the four schools where educational interventions were carried out with the children. The other four remained as a control group so as to make a comparison with the results obtained.

The research began with an anthropometric evaluation (weight and height) of all of the school children, both in the intervention group and the control group. The collection of the data included the distribution of questionnaires to parents, composed of 38 questions that covered the eating habits and the physical activities of their children, as well as the social economic condition of the family. For the second phase, the research team developed four educational games, which later would serve as a base for the commercial game. For example, the game concerning memory dealt with the theme of equivalent food, according to their function and nutritional value. Another, named the pyramid, allowed for the exploration of various possibilities to make up a balanced diet. The educational story tale also presented concepts related to a balanced diet and healthy food habits.

It was up to the school teachers to look after the proposed activities during lesson hours. There were fifteen hours of activities per semester, during the period of the academic year. For this the teachers received training that consisted of a university extension course of forty hours duration. “The training had as its objective the transmission of knowledge that would result in attitudes and practices directed towards the lowering of the consumption of salt, of saturated fats and of simple carbohydrates (sweets for example), as well as promoting an increase in physical activities”, says Taddei. At the end of the research the evaluation procedures of the first phase were repeated in order to make a comparative analysis and the statistics of the obtained results through educational intervention were directed towards the teachers, and by a table, to the pupils.

The results that became evident were a decrease in excessive consumption of sweets and industrialized snacks, a practice defined by the researchers as more than two portions consumed during four or more days of the week, within the groups of pupils who were exposed to the educational exercises. The project also brought about in the pupils a greater interest for lessons on physical education. There was a significant change observed with respect to the behavior of the teachers, who also felt themselves motivated to increase their level of physical activity.

Obesity and television
Another piece of important data also appeared at the start of the research. The evaluation of weight pointed out that 10.5% of the students who participated in the project were overweight, a percentage that represents more than double the 4.5% registered among Brazilian children during the last national piece of research into food and nutrition, carried out in 1989. According to the researchers, this result is comparable to the increase in obesity observed among the country’s schools over the last few years. The number of hours that a child spends watching television also shows itself to be a factor that contributes to excessive weight, principally if this period of time goes beyond four hours per day.

The problem lies within a process of nutritional transition, in Taddei’s opinion. The children are consuming more salt, sugar and fats, with a reduction in the consumption of carbohydrate complexes (fruit, vegetables and whole cereals, for example, a situation that points towards an epidemic of obesity and its associated illnesses. The ease of modern life, with the consequent reduction of day to day physical activity, has contributed to aggravate this picture. “The goal of nutritional education developed within the school environment is to instruct children and adolescents on the general principles of nutrition, giving guidance towards specific behavior so that they become apt to making conscientious choices throughout their lives”, suggests Taddei. This shows, once again, that the school is the ideal place to promote the development of healthy habits.

The Project
Reduction in the risks of falling ill and dying during adolescence – RRAMM Project (nº 99/07581-0); Modality Regular Line of Research Assistance; Coordinator José Augusto Carrazedo Taddei – Unifesp; Investment R$ 38,108.00 (FAPESP)