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Curriculum materials and nutrition learning at the high school level
Feature Article Curriculum Materials and Nutrition Learning at the High School Level Hazel Taylor Spitze Games and other "discovery learning" teaching techniques were used in a two-week high school nutrition education program. Students were receptive to these methods and demonstrated positive change tendencies. Summary High school students were taught nutrition for two weeks using games and discovery learni,ng. Nutrition knowledge, assessed by preand post-test scores, improved significantly. Attitudes, measured by opinionnaire and anonymous letters solicited by the instructor, showed that many students had positive feelings toward learning nutrition; 62% i,n the post-measure felt that "nutrition is an exciting subject to study." Student food preferences were evaluated but did not show statistically significant changes. Among the tentative conclusions of the experimental program was that high school students can be interested in learning nutrition if appropriately varied teachi,ng techniques are used.
As home economists and others give increasing attention to nutrition and nutrition education, the need for techniques and materials to improve teaching effectiveness is keenly felt (1-3). Many kinds of techniques have been tried and evaluated, including learning by teaching (4), capitalizing upon ethnic foods (5), incorporating chemical determinations and biological feeding experiments (6), and "educational cookery" (7).
This article describes an exploration of the feasibility and effectiveness of using selected games and other teaching materials to provide secondary students the opportunity for discovery learning. During Fall, 1974, two freshman-sophomore home economics classes in a high school of 1,400 studied nutrition for ten days and a junior level health-occupations class for eight days, under the guidance of the author, for 50 minutes daily. Fifty students completed pre- and post-tests. Those absent on test days were eliminated from that portion of the analysis. Methods Evaluation Data Collection. Immediately prior to and immediately following this period of instruction, the regular teachers in these classes administered a nutrition knowledge test developed and supplied by the author.1· 2 Other tools for evaluating change included: 1) an opinionnaire; 2) selection of "the 15 foods I'd most like to eat tomorrow if these were all I could have;"3 and 3) an anonymous letter to the instruc'Reliability .of this test, as measured by the Kuder-RichardsoOn f.ormula 20, was .88. It c.ontained 311 items .of the true· false type, gr.ouped by subject int.o 49 questi.ons. Example: Which .of the foOl· l.owing statements ab.out fruits and vegetables are generally true? (Keyed T). . 1. M.ost pr.ovide s.ome minerals and vitamins. (T) 2. They are .often l.o~er·oal.orie f.o.ods. (T) 3. They are excellent s.ources .of pr.otein. 4. They pr.ovide bulk needed by the digestive system. (T) 5. They add c.ol.or and variety toO meals. (T) 6. They c.ontribute quite a loOt .of water toO the diet. (T) ·C.opiesare available f.or $2.00 fr.om IllinoOis Teacher, 351 Eduoati.on Bldg., University .of lilin.ois, Urbana, IL 61801. Permissi.on toO reo pr.oduce will be granted .on request. "Fifteen was a s.omewhat arbitrary number ch.osen toO all.ow en.ough f.o.ods toO coOver three meals and toO meet the number .of servings rec· .ommended in the F.our F.o.od Gr.oups guide with .one "extra."
THE AUTHOR is Professor, Home Economics Education, University of Illinois, 352 Education Bldg., Urbana, lL 61801. Vol. 8, No.2, April-June, 1976
tor. Items 1) and 2) were used as pre- and post-measures. A "cafeteria" of National Dairy Council food models (8) was used for the 15 food choices in order to provide a visual stimulus of a wide variety of foods. The models also simplified calculations of nutritional adequacy of the 15 foods for the day, since nutrient values are printed on the back of the models. Instructional materials and techniques used were primarily those developed at the University of Illinois (9, 10). Attempts were made to keep the atmosphere friendly and informal. The regular teachers remained in the classroom as observers while the author served as instructor. Objectives. Teaching objectives for the period included both cognitive and affective ones: 1) to increase interest in the study of nutrition; 2) to increase interest in improving diet; 3) to increase understanding of some relations between body functions and nutrient intake; 4) to increase knowledge of food sources of eight common nutrients; and 5) to dispel some common myths about nutrition. Learning Activities. Classroom activities during the ten days included: DAYS 1 AND 2: Introductions; explanation of why new instructor was there and expectations for the two weeks; administration of opinionnaire. Students played "The Calorie Game."4 Instructor used last few minutes for questions and discussion of what was learned from game. DAYS 3 AND 4: Students selected "the 15 foods I'd most like to eat tomorrow if these were all I could have" from a "cafeteria" of food models and played "The Nutrition Game."4 DAY 5: "What's in the Box?" Six foods were used with this technique (11), in which students asked instructor nutritional questions and tried to identify food in the box. To formulate questions and evaluate answers, "Comparison Cards" (12) and the charts "Nutritive Values of Common Foods in Percent of RDA" (13) were used as references. No non-nutritional questions about the food (e.g., Is it round or red?) were allowed, and all questions had to be answerable by yes or no. Winner was given the food. DAY 6: Students played a game, developed by the author, to learn about anemia and food sources of iron. A deck of cards with names and pictures of foods (but no nutrition information) was used along with nutritive values charts mentioned above. Each player drew two food cards, kept the one he/she felt had the most iron per serving, discarded the other, consulted the charts to see if the best choice had been made and recorded the amount of iron obtained. The winner was the first person at each table to reach 100% RDA for iron. Explanations about iron deficiency anemia were given during the game. (The 1968 RDA for the woman 22-35 was used as the base.) DAY 7: Another technique, "Recognizing One-Nutrient Deficiencies" (Ref. 11, p. 150) was used. It displays three meals a day for four days, using food models, with each day's meals having near 100% RDA in all but one of the following nutrients: protein, calcium, iron, vitamin A, thiamin, riboflavin, 'Reviewed in J. Nutr. Educ., 5:27, 1973. Journal of NUTRITION EDUCATION / 59
Table I Number of Students in Three High School Classes Agreeing with Selected Statements on Pre- and Post-Opinionnaires n = 50 "I think nutrition is an exciting subject to study." "I think nutrition is a dull subject." "I·d like to find out whether my body's needs are being met by what I eat." "I think it is important for everyone to understand his nutritional .needs." "I think too much emphasis is being put on nutrition." "What one eats can affect his health." "What one eats can affect his personality." "What one eats can affect how well he can learn."
Pre13 12
Post3.1
39
48
39 2 49 35 31
45 0 49 40 41
niacin and vitamin C. The deficient nutrient, different for each day's meals, was present at less than 50% RDA. Students discovered the "unknown" by consulting nutritive values charts (13) and "Comparison Cards" (12). If they finished before the class was over, they were given a Self-Teaching Kit 5 to work on for the rest of the time. DAY 8: Five students presented a skit "For Lack of Niacin" (14), while the "audience" listened for symptoms of niacin deficiency. A short discussion followed. For the rest of the period, students were encouraged to ask questions. The instructor asked some, answered some, and directed students in use of reference materials to find answers to others. DAY 9: Students wrote-on request-anonymous letters to the instructor to share opinions on class activities. "Matching Foods and Nutrient Values" (self-teaching technique) utilized the rest of the hour. Thirteen groups of five foods and five sets of nutritive values each were available for matching, and students worked at their own pace. 6 They matched the foods with the knowledge they had "in their heads" and then used the nutritive value charts for checking and correction. DAY 10: Opinionnaire; selection of 15 foods (as in Day 3). Results and Discussion Knowledge. The nutrition knowledge test was used as a preand post-measure to assess knowledge gain of the 50 students. The difference between mean pre- and posttest scores for the three classes was + 29, + 28 and + 18 (the last for the class that met only 8 days). All were statistically significant (.001 level). Opinionnaire. Fifty students from the three classes completed both pre- and post-opinionnaires, one purpose of which was to inquire about their attitude regarding nutrition as a subject for study. The directions were to "check each of the following 20 items with which you agree and leave the others blank." A considerable shift toward a more positive attitude was noted by student responses to two items as shown in Table 1. Additional items from the opinionnaire, while showing little or no difference between pre- and post-measure, provide additional insights into some of the students' feelings and values. "Further informatien is contained in free brochures of Innovative Teaching Techniques materials and in the journal "Illinois Teach. er." For address, see footnote 2. "Example: In the blank to the right of each "nutrient description," write the name of the food it matches using each of the following: orange, grape juice, spinach, canned plums and salmon. Numbers represent the % RDA using as the base 100% 1968 RDA f(}r the 22·35 year old woman. Protein Calcium Iron Vito A Vito B-1 Vito B-2 Niacin Vito C 7 3 5 13 3 4 120 2 12205220 1 1 6 30 2 2 3 4 5 13 13 144 1 7 2 22 31 21 4 1 3 11 52 0 60 / Journal of NUTRITION EDUCATION
Food Selections. The nutrient values of the foods chosen by the 50 students as "the 15 foods I'd most like to eat tomorrow if these were all I could have" were evaluated using figures on the back of the food models for seven nutrients: protein, calcium, iron, vitamin A, thiamin, riboflavin, and vitamin C. (Niacin was not included on the models.) Number of calories was also recorded. Changes in the pre- and post-measure were in the direction of improved nutrition but were not statistically significant. The "cafeteria" from which the foods were chosen contained 84 foods. Food preferences indicated that some foods were chosen 19 times as often as others, while 13 foods were not chosen at all. Foods chosen most often were (numbers indicate number of times chosen): eggs (scrambled, boiled, poached, or creamed)-19; oranges or orange juice-19; milk-18; tomato, tomato juice, or tomato soup-16; hamburger on bun-16; bacon-16; layer cake, sponge cake, or cup cake"':""'14; soft drink-14; ice cream-13; baked potato -13; and French fries-ll. The students' choices may suggest that when teenagers choose less nutritious foods, as they often do, it is because the nutritious ones are not as easily available, they cost more, or for some other reason not directly related to their food preferences. Of course they may have chosen here the foods they felt they "ought" to choose, but that is one factor in any decision of what to eat. With different alternatives available, their choices might have been different. When the nutrient value of the students' selections of 15 foods was evaluated, the nutrients most frequently in low supply (less than 75% RDA) were iron, calcium, and vitamin A. A few students' choices were low in thiamin or riboflavin, but nearly all were adequate in vitamin C. All but one "diet" contained at least 100% RDA for protein. Most contained far more than that, the mean for both classes being near 200%. We recognized, of course, that we were considering only the adequacy of the chosen 15 food models and not the adequacy of the students' actual diets nor of what they might choose in a real situation with different, probably more limited, choices available. Areas of Understanding and Misunderstanding. At least half of the students answered 251 of the 311 items correctly on the post-test_ On 18 items, 90% or more answered correctly, recognizing such relationships as: prenatal diet affects fetal brain development; nutrient needs are greater during pregnancy; eggs supply protein; and protein is needed for body structure. They knew that anemia is caused by poor diet and that bones and skin are also affected by dietary deficiencies. They were aware that energy need is related to activity. They recognized that calcium is needed for bones and teeth and that cheese is one good source. They were aware that long heating destroys vitamin C and that soft drinks are not very nutritious. Some of the areas of misunderstanding about nutrition are indicated by items missed on the post-test by half or more of the students. Examples: They thought that vitamins provided energy for the body and that more protein was needed when a person is very active. They did not know that soft drinks had energy value nor that pizza can be a source of calcium. They thought certain single foods (e.g. milk) had all the nutrients needed by the adult. They were unaware that potatoes, broccoli, and turnip greens were good sources of vitamin C, and they thought that celery was a good source. They thought meat was a good source of vitamin A but pumpkin pie was not. They did not know which nutrients had a special function in clotting of the blood. Vol. 8, No.2, April-June, 1976
They did not know which vitamins were water soluble nor that freezing was less destructive of vitamin C than other preservation methods. They did not recognize a standard serving of milk or meat. They thought that anyone who ate food servings recommended in the Four Food Groups guide was guaranteed an adequate amount of all nutrients and that anyone who did not was bound to be short in some nutrients. Possible explanations for the misunderstandings are: 1) two weeks was not enough time to cover all principles on which students were tested; 2) materials used covered these areas less well than other areas taught; 3) these areas may be more difficult to teach and may require more repetition; 4) these areas may represent widely-believed myths; 5) these areas may run counter to commonly-held attitudes, making learning more difficult. Insights from the Anonymous Letters. In the anonymous letters written at the end of the period of instruction, students answered frankly the question "What did you like most and least about what we've done during class to learn about nutrition?" Of the 55 students present that day, 47 commented about the educational games, probably because they were unaccustomed to the use of games as a teaching-learning technique. Forty-one of them commented favorably, most enthusiastically. Six commented unfavorably saying either that they did not like to play games or they did not feel that they learned very much playing games. Some of the favorable comments were: "Playing the games makes you stop and think about the foods that you thought had a lot of nutrition. I think more people in our world should know more about nutrition. Maybe there would be less sickness going around." "At first I thought this nutrition class would be boring, but I liked playing the games and learning about the vitamins our bodies need each day. They got the point across." "The games were fun and educational. I think you learn more when you enjoy what you're doing. Games get students' attention." Nine students mentioned that they were "glad I d:d not lecture," and three added that the "day they liked least was the one when "we spent a lot of time with questions and answers." Three commented favorably about the skit "For Lack of Niacin," and no unfavorable comments were made about it. One student said she did not like "that test we had to take before you came." Other quotes from the letters reveal feelings about the subject and the way it was taught: "I enjoyed being able to learn about nutrition without having to read or be lectured to. You let us learn by finding out ourselves in a way we all enjoyed."
"I always knew that nutrition was important, but 1 never really realized how important." "I always considered nutrition stuffy and boring, but these two weeks weren't bad at all." "Without realizing it, I actually learned something! I learned I haven't always eaten the food I should." "I liked the way you didn't say 'This is it, and there's no other way,' and you put things in games instead of lectures." Tentative Conclusions Some of the tentative conclusions I have drawn from the experience of this study follow: 1) These high school students can be interested in studying nutrition, but they do not want to do so by reading books, listening to lectures, and taking tests. 2) Two weeks was not enough! Most students would have been glad to ,continue longer. 3) Although many important nutritional concepts were included in the games in the study, additional materials and/ or activities were needed for many other concepts. 4) These students' food preferences, as measured by their choice of 15 food models, would supply a fairly adequate diet, but iron, calcium and vitamin A were nutrients at lower levels. 5) For this group, the games utilized in the study were effective techniques in both cognitive and affective areas. REFERENCES 1. Leverton, R., Tools for teaching food needs, J. Home Econ., 65 (No. 1):37, Jan. 1973. 2. Schwartz, N. E., J. Dalrymple and V.M. Vivian, High school nutdtion education: How effective is it? J. Home Econ., 66 (No.5): 16, May 1974. 3. Head, M. K., A nutrition education program at three grade levels, 1. Nutr. Educ., 6:56, 1974. 4. Mills, E. R., Applying learning theory in teaching nutrition, J. Nutr. Educ., 4: 106, 1973. 5. Cowell, C. and O.E. Sobilsohn, Stirring the cultural melting pot, J. Home Econ., 65 (No.7) :20, Oct. 1973. 6. Picardi, S. M. ,and E.R. Pariser, Food and nutrition minicourse for 11th and 12th grades, J. Nutr. Educ., 7:25,1975. 7. Rickard, K. and S. Farnum, Food for fun and thought: Nutrition education in a children's hospital, 1. Amer. Dietet. Assn., 65:294,1974. 8. Food Models, National Dairy Council, Rosemont, Ill., 1972. 9. Spitze, H. T., Innovative techniques for teaching nutrition, J. Nutr. Educ., 2: 156, 1971. 10. Spitze, H. T., Games that teach, J. Home Econ., 64(No. 4): 8, April 1972. 11. Spitze, H. T., What's in the box? and Oppert, J., Recognizing one-nutrient deficiencies, Illinois Teacher, 17:146, 150, 1974. 12. Comparison Cards, National Dairy Council, Rosemont, Ill., 1969. 13. VanderJagt, G., Nutrient Values of Common Foods in Percent of RDA, Div. of Home Economics Education, University of Illinois, Urbana, 1971.
"We need crossbreeding between English teachers and nutrition sciences-not just to keep English teachers from promoting vitamin E when it won't do any good, but to help the nutrition scientists write a good sentence which a reader can understand."
"If the food industry were to become less defensive, public suspicion would probably decrease. The educated section of the public increasingly seeks information about the ingredients and nutritive value of manufactured foods. Wherever possible this information should be made available even at the risk of misunderstanding by those who are not scientifically educated." Dorothy Hollingsworth, Director General, British Nutrition Foundation, London, U.K.
Jean Voltz, Food Editor, Woman's Day, New York City
"I think everyone involved in the area of food-whether in production, distri-
Notable & Quotable I
Nutrition and the Public
Vol. 8, No.2, April-June, 1976
bution and marketing, or promotionshould recognize that no program can be expected to cut off criticism, negative comments, etc. The goal of the program can't be to 'silence the objectors' but to make sure that the public receives a reasonable balance in terms of the comments that are being presented." Ogden Johnson, Ph.D., Director of Research, Hershey Foods Co., Hershey, Pa. The above quotes are taken from Nutrition and the Public, proceedings of a Symposium held at Marabou, Sundbyberg, Sweden, Aug. 1975. Journal of NUTRITION EDUCATION I 61
As home economists and others give increasing attention to nutrition and nutrition education, the need for techniques and materials to improve teaching effectiveness is keenly felt (1-3). Many kinds of techniques have been tried and evaluated, including learning by teaching (4), capitalizing upon ethnic foods (5), incorporating chemical determinations and biological feeding experiments (6), and "educational cookery" (7).
This article describes an exploration of the feasibility and effectiveness of using selected games and other teaching materials to provide secondary students the opportunity for discovery learning. During Fall, 1974, two freshman-sophomore home economics classes in a high school of 1,400 studied nutrition for ten days and a junior level health-occupations class for eight days, under the guidance of the author, for 50 minutes daily. Fifty students completed pre- and post-tests. Those absent on test days were eliminated from that portion of the analysis. Methods Evaluation Data Collection. Immediately prior to and immediately following this period of instruction, the regular teachers in these classes administered a nutrition knowledge test developed and supplied by the author.1· 2 Other tools for evaluating change included: 1) an opinionnaire; 2) selection of "the 15 foods I'd most like to eat tomorrow if these were all I could have;"3 and 3) an anonymous letter to the instruc'Reliability .of this test, as measured by the Kuder-RichardsoOn f.ormula 20, was .88. It c.ontained 311 items .of the true· false type, gr.ouped by subject int.o 49 questi.ons. Example: Which .of the foOl· l.owing statements ab.out fruits and vegetables are generally true? (Keyed T). . 1. M.ost pr.ovide s.ome minerals and vitamins. (T) 2. They are .often l.o~er·oal.orie f.o.ods. (T) 3. They are excellent s.ources .of pr.otein. 4. They pr.ovide bulk needed by the digestive system. (T) 5. They add c.ol.or and variety toO meals. (T) 6. They c.ontribute quite a loOt .of water toO the diet. (T) ·C.opiesare available f.or $2.00 fr.om IllinoOis Teacher, 351 Eduoati.on Bldg., University .of lilin.ois, Urbana, IL 61801. Permissi.on toO reo pr.oduce will be granted .on request. "Fifteen was a s.omewhat arbitrary number ch.osen toO all.ow en.ough f.o.ods toO coOver three meals and toO meet the number .of servings rec· .ommended in the F.our F.o.od Gr.oups guide with .one "extra."
THE AUTHOR is Professor, Home Economics Education, University of Illinois, 352 Education Bldg., Urbana, lL 61801. Vol. 8, No.2, April-June, 1976
tor. Items 1) and 2) were used as pre- and post-measures. A "cafeteria" of National Dairy Council food models (8) was used for the 15 food choices in order to provide a visual stimulus of a wide variety of foods. The models also simplified calculations of nutritional adequacy of the 15 foods for the day, since nutrient values are printed on the back of the models. Instructional materials and techniques used were primarily those developed at the University of Illinois (9, 10). Attempts were made to keep the atmosphere friendly and informal. The regular teachers remained in the classroom as observers while the author served as instructor. Objectives. Teaching objectives for the period included both cognitive and affective ones: 1) to increase interest in the study of nutrition; 2) to increase interest in improving diet; 3) to increase understanding of some relations between body functions and nutrient intake; 4) to increase knowledge of food sources of eight common nutrients; and 5) to dispel some common myths about nutrition. Learning Activities. Classroom activities during the ten days included: DAYS 1 AND 2: Introductions; explanation of why new instructor was there and expectations for the two weeks; administration of opinionnaire. Students played "The Calorie Game."4 Instructor used last few minutes for questions and discussion of what was learned from game. DAYS 3 AND 4: Students selected "the 15 foods I'd most like to eat tomorrow if these were all I could have" from a "cafeteria" of food models and played "The Nutrition Game."4 DAY 5: "What's in the Box?" Six foods were used with this technique (11), in which students asked instructor nutritional questions and tried to identify food in the box. To formulate questions and evaluate answers, "Comparison Cards" (12) and the charts "Nutritive Values of Common Foods in Percent of RDA" (13) were used as references. No non-nutritional questions about the food (e.g., Is it round or red?) were allowed, and all questions had to be answerable by yes or no. Winner was given the food. DAY 6: Students played a game, developed by the author, to learn about anemia and food sources of iron. A deck of cards with names and pictures of foods (but no nutrition information) was used along with nutritive values charts mentioned above. Each player drew two food cards, kept the one he/she felt had the most iron per serving, discarded the other, consulted the charts to see if the best choice had been made and recorded the amount of iron obtained. The winner was the first person at each table to reach 100% RDA for iron. Explanations about iron deficiency anemia were given during the game. (The 1968 RDA for the woman 22-35 was used as the base.) DAY 7: Another technique, "Recognizing One-Nutrient Deficiencies" (Ref. 11, p. 150) was used. It displays three meals a day for four days, using food models, with each day's meals having near 100% RDA in all but one of the following nutrients: protein, calcium, iron, vitamin A, thiamin, riboflavin, 'Reviewed in J. Nutr. Educ., 5:27, 1973. Journal of NUTRITION EDUCATION / 59
Table I Number of Students in Three High School Classes Agreeing with Selected Statements on Pre- and Post-Opinionnaires n = 50 "I think nutrition is an exciting subject to study." "I think nutrition is a dull subject." "I·d like to find out whether my body's needs are being met by what I eat." "I think it is important for everyone to understand his nutritional .needs." "I think too much emphasis is being put on nutrition." "What one eats can affect his health." "What one eats can affect his personality." "What one eats can affect how well he can learn."
Pre13 12
Post3.1
39
48
39 2 49 35 31
45 0 49 40 41
niacin and vitamin C. The deficient nutrient, different for each day's meals, was present at less than 50% RDA. Students discovered the "unknown" by consulting nutritive values charts (13) and "Comparison Cards" (12). If they finished before the class was over, they were given a Self-Teaching Kit 5 to work on for the rest of the time. DAY 8: Five students presented a skit "For Lack of Niacin" (14), while the "audience" listened for symptoms of niacin deficiency. A short discussion followed. For the rest of the period, students were encouraged to ask questions. The instructor asked some, answered some, and directed students in use of reference materials to find answers to others. DAY 9: Students wrote-on request-anonymous letters to the instructor to share opinions on class activities. "Matching Foods and Nutrient Values" (self-teaching technique) utilized the rest of the hour. Thirteen groups of five foods and five sets of nutritive values each were available for matching, and students worked at their own pace. 6 They matched the foods with the knowledge they had "in their heads" and then used the nutritive value charts for checking and correction. DAY 10: Opinionnaire; selection of 15 foods (as in Day 3). Results and Discussion Knowledge. The nutrition knowledge test was used as a preand post-measure to assess knowledge gain of the 50 students. The difference between mean pre- and posttest scores for the three classes was + 29, + 28 and + 18 (the last for the class that met only 8 days). All were statistically significant (.001 level). Opinionnaire. Fifty students from the three classes completed both pre- and post-opinionnaires, one purpose of which was to inquire about their attitude regarding nutrition as a subject for study. The directions were to "check each of the following 20 items with which you agree and leave the others blank." A considerable shift toward a more positive attitude was noted by student responses to two items as shown in Table 1. Additional items from the opinionnaire, while showing little or no difference between pre- and post-measure, provide additional insights into some of the students' feelings and values. "Further informatien is contained in free brochures of Innovative Teaching Techniques materials and in the journal "Illinois Teach. er." For address, see footnote 2. "Example: In the blank to the right of each "nutrient description," write the name of the food it matches using each of the following: orange, grape juice, spinach, canned plums and salmon. Numbers represent the % RDA using as the base 100% 1968 RDA f(}r the 22·35 year old woman. Protein Calcium Iron Vito A Vito B-1 Vito B-2 Niacin Vito C 7 3 5 13 3 4 120 2 12205220 1 1 6 30 2 2 3 4 5 13 13 144 1 7 2 22 31 21 4 1 3 11 52 0 60 / Journal of NUTRITION EDUCATION
Food Selections. The nutrient values of the foods chosen by the 50 students as "the 15 foods I'd most like to eat tomorrow if these were all I could have" were evaluated using figures on the back of the food models for seven nutrients: protein, calcium, iron, vitamin A, thiamin, riboflavin, and vitamin C. (Niacin was not included on the models.) Number of calories was also recorded. Changes in the pre- and post-measure were in the direction of improved nutrition but were not statistically significant. The "cafeteria" from which the foods were chosen contained 84 foods. Food preferences indicated that some foods were chosen 19 times as often as others, while 13 foods were not chosen at all. Foods chosen most often were (numbers indicate number of times chosen): eggs (scrambled, boiled, poached, or creamed)-19; oranges or orange juice-19; milk-18; tomato, tomato juice, or tomato soup-16; hamburger on bun-16; bacon-16; layer cake, sponge cake, or cup cake"':""'14; soft drink-14; ice cream-13; baked potato -13; and French fries-ll. The students' choices may suggest that when teenagers choose less nutritious foods, as they often do, it is because the nutritious ones are not as easily available, they cost more, or for some other reason not directly related to their food preferences. Of course they may have chosen here the foods they felt they "ought" to choose, but that is one factor in any decision of what to eat. With different alternatives available, their choices might have been different. When the nutrient value of the students' selections of 15 foods was evaluated, the nutrients most frequently in low supply (less than 75% RDA) were iron, calcium, and vitamin A. A few students' choices were low in thiamin or riboflavin, but nearly all were adequate in vitamin C. All but one "diet" contained at least 100% RDA for protein. Most contained far more than that, the mean for both classes being near 200%. We recognized, of course, that we were considering only the adequacy of the chosen 15 food models and not the adequacy of the students' actual diets nor of what they might choose in a real situation with different, probably more limited, choices available. Areas of Understanding and Misunderstanding. At least half of the students answered 251 of the 311 items correctly on the post-test_ On 18 items, 90% or more answered correctly, recognizing such relationships as: prenatal diet affects fetal brain development; nutrient needs are greater during pregnancy; eggs supply protein; and protein is needed for body structure. They knew that anemia is caused by poor diet and that bones and skin are also affected by dietary deficiencies. They were aware that energy need is related to activity. They recognized that calcium is needed for bones and teeth and that cheese is one good source. They were aware that long heating destroys vitamin C and that soft drinks are not very nutritious. Some of the areas of misunderstanding about nutrition are indicated by items missed on the post-test by half or more of the students. Examples: They thought that vitamins provided energy for the body and that more protein was needed when a person is very active. They did not know that soft drinks had energy value nor that pizza can be a source of calcium. They thought certain single foods (e.g. milk) had all the nutrients needed by the adult. They were unaware that potatoes, broccoli, and turnip greens were good sources of vitamin C, and they thought that celery was a good source. They thought meat was a good source of vitamin A but pumpkin pie was not. They did not know which nutrients had a special function in clotting of the blood. Vol. 8, No.2, April-June, 1976
They did not know which vitamins were water soluble nor that freezing was less destructive of vitamin C than other preservation methods. They did not recognize a standard serving of milk or meat. They thought that anyone who ate food servings recommended in the Four Food Groups guide was guaranteed an adequate amount of all nutrients and that anyone who did not was bound to be short in some nutrients. Possible explanations for the misunderstandings are: 1) two weeks was not enough time to cover all principles on which students were tested; 2) materials used covered these areas less well than other areas taught; 3) these areas may be more difficult to teach and may require more repetition; 4) these areas may represent widely-believed myths; 5) these areas may run counter to commonly-held attitudes, making learning more difficult. Insights from the Anonymous Letters. In the anonymous letters written at the end of the period of instruction, students answered frankly the question "What did you like most and least about what we've done during class to learn about nutrition?" Of the 55 students present that day, 47 commented about the educational games, probably because they were unaccustomed to the use of games as a teaching-learning technique. Forty-one of them commented favorably, most enthusiastically. Six commented unfavorably saying either that they did not like to play games or they did not feel that they learned very much playing games. Some of the favorable comments were: "Playing the games makes you stop and think about the foods that you thought had a lot of nutrition. I think more people in our world should know more about nutrition. Maybe there would be less sickness going around." "At first I thought this nutrition class would be boring, but I liked playing the games and learning about the vitamins our bodies need each day. They got the point across." "The games were fun and educational. I think you learn more when you enjoy what you're doing. Games get students' attention." Nine students mentioned that they were "glad I d:d not lecture," and three added that the "day they liked least was the one when "we spent a lot of time with questions and answers." Three commented favorably about the skit "For Lack of Niacin," and no unfavorable comments were made about it. One student said she did not like "that test we had to take before you came." Other quotes from the letters reveal feelings about the subject and the way it was taught: "I enjoyed being able to learn about nutrition without having to read or be lectured to. You let us learn by finding out ourselves in a way we all enjoyed."
"I always knew that nutrition was important, but 1 never really realized how important." "I always considered nutrition stuffy and boring, but these two weeks weren't bad at all." "Without realizing it, I actually learned something! I learned I haven't always eaten the food I should." "I liked the way you didn't say 'This is it, and there's no other way,' and you put things in games instead of lectures." Tentative Conclusions Some of the tentative conclusions I have drawn from the experience of this study follow: 1) These high school students can be interested in studying nutrition, but they do not want to do so by reading books, listening to lectures, and taking tests. 2) Two weeks was not enough! Most students would have been glad to ,continue longer. 3) Although many important nutritional concepts were included in the games in the study, additional materials and/ or activities were needed for many other concepts. 4) These students' food preferences, as measured by their choice of 15 food models, would supply a fairly adequate diet, but iron, calcium and vitamin A were nutrients at lower levels. 5) For this group, the games utilized in the study were effective techniques in both cognitive and affective areas. REFERENCES 1. Leverton, R., Tools for teaching food needs, J. Home Econ., 65 (No. 1):37, Jan. 1973. 2. Schwartz, N. E., J. Dalrymple and V.M. Vivian, High school nutdtion education: How effective is it? J. Home Econ., 66 (No.5): 16, May 1974. 3. Head, M. K., A nutrition education program at three grade levels, 1. Nutr. Educ., 6:56, 1974. 4. Mills, E. R., Applying learning theory in teaching nutrition, J. Nutr. Educ., 4: 106, 1973. 5. Cowell, C. and O.E. Sobilsohn, Stirring the cultural melting pot, J. Home Econ., 65 (No.7) :20, Oct. 1973. 6. Picardi, S. M. ,and E.R. Pariser, Food and nutrition minicourse for 11th and 12th grades, J. Nutr. Educ., 7:25,1975. 7. Rickard, K. and S. Farnum, Food for fun and thought: Nutrition education in a children's hospital, 1. Amer. Dietet. Assn., 65:294,1974. 8. Food Models, National Dairy Council, Rosemont, Ill., 1972. 9. Spitze, H. T., Innovative techniques for teaching nutrition, J. Nutr. Educ., 2: 156, 1971. 10. Spitze, H. T., Games that teach, J. Home Econ., 64(No. 4): 8, April 1972. 11. Spitze, H. T., What's in the box? and Oppert, J., Recognizing one-nutrient deficiencies, Illinois Teacher, 17:146, 150, 1974. 12. Comparison Cards, National Dairy Council, Rosemont, Ill., 1969. 13. VanderJagt, G., Nutrient Values of Common Foods in Percent of RDA, Div. of Home Economics Education, University of Illinois, Urbana, 1971.
"We need crossbreeding between English teachers and nutrition sciences-not just to keep English teachers from promoting vitamin E when it won't do any good, but to help the nutrition scientists write a good sentence which a reader can understand."
"If the food industry were to become less defensive, public suspicion would probably decrease. The educated section of the public increasingly seeks information about the ingredients and nutritive value of manufactured foods. Wherever possible this information should be made available even at the risk of misunderstanding by those who are not scientifically educated." Dorothy Hollingsworth, Director General, British Nutrition Foundation, London, U.K.
Jean Voltz, Food Editor, Woman's Day, New York City
"I think everyone involved in the area of food-whether in production, distri-
Notable & Quotable I
Nutrition and the Public
Vol. 8, No.2, April-June, 1976
bution and marketing, or promotionshould recognize that no program can be expected to cut off criticism, negative comments, etc. The goal of the program can't be to 'silence the objectors' but to make sure that the public receives a reasonable balance in terms of the comments that are being presented." Ogden Johnson, Ph.D., Director of Research, Hershey Foods Co., Hershey, Pa. The above quotes are taken from Nutrition and the Public, proceedings of a Symposium held at Marabou, Sundbyberg, Sweden, Aug. 1975. Journal of NUTRITION EDUCATION I 61