Develop a Participatory Model in Nutrition Education to Prevent Childhood Obesity


Purpose: To investigate the effect of nutrition education and the engagement of students, parents and teachers in addressing school-specific environmental influences in eating problem. Design: This study adopted the action research process of diagnosing, action planning, taking action, evaluating, and specifying learning. Each of obese and non-obese male and female students was randomly selected based on physical screening based on obesity criteria. Dietary intake records were taken over seven days as the pre-intervention period. These four students, one of each of their parents and the teacher from the primary school, were given 3 sessions of nutrition education. After the nutrition education, dietary intake records were taken over the subsequent 7 days as the post-intervention period. Lunch observation and lunch menu review were included to identify eating problem of primary school children in school level. Findings: Students were found to consume less whole grains and more food items belonged to the “limited” and “strongly discouraged” as set in government lunch guidelines. Students’ dietary intakes before and after the nutrition education were found improved in their energy intake (p = 0.012), total fat, saturated fat, calcium, sodium, and cholesterol. Conclusion: A participatory model in elementary nutrition education could be effective.

Share and Cite:

Chung, L. and Chung, J. (2015) Develop a Participatory Model in Nutrition Education to Prevent Childhood Obesity. Health, 7, 466-475. doi: 10.4236/health.2015.74055.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Baur, L., Lobstein, T. and Uauy, R. (2004) Obesity in Children and Young People: A Crisis in Public Health. Obesity Reviews, 5, 4-85.
[2] Lobstein, T. and Frelut, M.L. (2003) Prevalence of Overweight among Children in Europe. Obesity Reviews, 4, 195- 200.
[3] Cole, T.J., Bellizzi, M.C., Flegal, K.M. and Dietz, W.H. (2000) Establishing a Standard Definition for Child Overweight and Obesity Worldwide: International Survey. British Medical Journal, 320, 1240-1243.
[4] Group of China Obesity Task Force (2004) Body Mass Index Reference Norm for Screening Overweight and Obesity in Chinese Children and Adolescents. Zhonghua Liu Xing Bing Xue Za Zhi, 25, 97-102.
[5] Ogden, C.L., Kuczmarski, R.J., Flegal, K.M., Mei, Z., Guo, S., Wei, R., Grummer-Strawn, L.M., Curtin, L.R., Roche, A.F. and Johnson, C.L. (2002) Centers for Disease Control and Prevention 2000 Growth Charts for the United States: Improvements to the 1977 National Center for Health Statistics Version. Pediatrics, 109, 45-60.
[6] Leung, S.S.F., Lau, J.T.F., Tse, L.Y. and Oppenheimer, S.J. (1996) Weight-for-Age and Weight-for-Height References for Hong Kong Children from Birth to 18 Years. Journal of Paediatrics and Child Health, 32, 103-109.
[7] Department of Health, Government of Hong Kong Special Administrative Region (2007) Baseline Assessment of Promoting Healthy Eating in Primary Schools: Supplementary Report on School Lunch.
[8] Hill, A.J. and Silver, E.K. (1995) Fat, Friendless and Unhealthy: 9-Year Old Children’s Perception of Body Shape Stereotypes. International Journal of Obesity and Related Metabolic Disorders, 19, 423-430.
[9] Hui, L.L., Nelson, E.A.S., Yu, L.M., Li, A.M. and Fok, T.K. (2003) Risk Factors for Childhood Overweight in 6- to 7-Year-Old Hong Kong Children. International Journal of Obesity and Related Metabolic Disorders, 27, 1411-1418.
[10] Csabi, G., Torok, K., Jeges, S. and Molnar, D. (2000) Presence of Metabolic Cardiovascular Syndrome in Obese Children. European Journal of Pediatrics, 159, 91-94.
[11] Lumeng, J.C., Gannon, K., Cabral, H.J., Frank, D.A. and Zuckerman, B. (2003) Association between Clinically Meaningful Behavior Problems and Overweight in Children. Pediatrics, 112, 1138-1145.
[12] Cornette, R. (2008) The Emotional Impact of Obesity on Children. Worldviews on Evidence-Based Nursing, 5, 136-141.
[13] Hill, A.J., Draper, E. and Stack, J. (1994) A weight on Children’s Minds: Body Shape Dissatisfactions at 9 Years Old. International Journal of Obesity and Related Metabolic Disorders, 18, 383-389.
[14] Chen, W., Bao, W., Begum, S., Elekasabany, A., Srinivasan, S.R. and Berenson, G.S. (2000) Age-Related Patterns of the Clustering of Cardiovascular Risk Variables of Syndrome X from Childhood to Young Adulthood in a Population Made Up of Black and White Subjects: The Bogalusa Heart Study. Diabetes, 49, 1042-1048.
[15] Freedman, D.S., Mei, Z., Srinivasan, S.R., Berenson, G.S. and Dietz, W.H. (2007) Cardiovascular Risk Factors and Excess Adiposity among Overweight Children and Adolescents: The Bogalusa Heart Study. Journal of Pediatrics, 150, 12-17.e2.
[16] Kong, A.P., Choi, K.C., Ko, G.T., Wong, G.W., Ozaki, R., So, W.Y., Tong, P.C. and Chan, J.C. (2008) Associations of Overweight with Insulin Resistance, Beta-Cell Function and Inflammatory Markers in Chinese Adolescents. Pediatric Diabetes, 9, 488-495.
[17] National Heart Lung and Blood Institute (1998) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adult. The Evidence Report 1998, National Institutes of Health, USA, 1.
[18] Gerald, I.S. (1983) Action Research: A Sociotechnical Systems Perspective. Edited by Morgan, G., Sage Publications, London, 102.
[19] Spalding, N.J. (2009) Improving Practice through Involvement in Action Research. International Journal of Therapy and Rehabilitation, 16, 130-138.
[20] Hart, E. and Bond, M. (1995) Action Research for Health and Social Care: A Guide to Practice. Open University Press, Buckingham.
[21] Chung, L.M.Y. and Chung, J.W.Y. (2010) Tele-Dietetics with Food Images as Dietary Intake Records in Nutrition Assessment. Telemedicine and e-Health, 16, 691-698.
[22] Chung, L.M.Y., Chung, J.W.Y. and Wong, T.K.S. (2009) Usability Test of an Interactive Dietary Recording. Global Journal of Health Education and Promotion, 12, 123-134.
[23] Johns, D.P. and Shuttleworth, J.J. (1996) Present Practices, Future Discourses: Addressing Context and Relevancy of Contemporary Professional Practice. Journal of Primary Education, 6, 57-65.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.