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Aalborg Universitet

Pilot European Regional Interventions for Smart Childhood Obesity Prevention in EarlyageReport on the interventions in Danish kindergartens

Sansolios, Sanne; Mikkelsen, Bent Egberg

Published in:Pilot European Regional Interventions for Smart Childhood Obesity Prevention in Early age

Publication date:2010

Document VersionEarly version, also known as pre-print

Link to publication from Aalborg University

Citation for published version (APA):Sansolios, S., & Mikkelsen, B. E. (2010). Pilot European Regional Interventions for Smart Childhood ObesityPrevention in Early age: Report on the interventions in Danish kindergartens. In Pilot European RegionalInterventions for Smart Childhood Obesity Prevention in Early age: Report on the interventions in Danishkindergartens (pp. 1-32) http://www.en.periscope.aau.dk/digitalAssets/15/15040_periscope_report-on-the-interventions-in-danish-kindergartens.2009.pdf

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PILOT E

EUROPEANN REGION

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Proje

NAL INTER

PREVENT

(P

EPORT ON

IN DANIS

ect no. 2006

RVENTION

TION IN EA

PERISCOP

N THE INTE

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6341 

NS FOR SM

ARLY AGE

E) 

ERVENTIO

RGARTENS

MART CHIL

ONS  

S 

LDHOOD OOBESITY 

Sanne Sansolios 

& 

Bent Egberg Mikkelsen 

MENU 

Mela Sciences and Public Health Nutrition  

Aalborg University, Denmark 

2009 

ContentsList of kindergartens attending the Periscope studies ...................................................................................... 5 

Enrolments of kindergartens ............................................................................................................................. 6 

Intervention and control kindergartens ............................................................................................................ 6 

Timeline ............................................................................................................................................................. 6 

Purpose of intervention ................................................................................................................................. 8 

Action components ....................................................................................................................................... 8 

Questionnaires .................................................................................................................................................. 8 

Focus group interviews...................................................................................................................................... 9 

Kindergartens as important arena ................................................................................................................ 9 

Stakeholders .................................................................................................................................................. 9 

Children FG .................................................................................................................................................. 10 

Children FG on Food .................................................................................................................................... 11 

Children FG on PA ........................................................................................................................................ 12 

Children drawing session ............................................................................................................................. 13 

Stakeholders GF on Food ............................................................................................................................. 13 

Stakeholders FG on PA ................................................................................................................................ 14 

Report of food intervention menu and taste workshop result in kindergarten ............................................. 17 

FOOD Baseline menu ................................................................................................................................... 17 

FOOD Intervention menu ............................................................................................................................ 17 

Intervention menu results ........................................................................................................................... 18 

Taste workshop ............................................................................................................................................... 21 

Sapere method ............................................................................................................................................ 22 

Protocol for Sapere Taste workshop ........................................................................................................... 23 

Day one: ................................................................................................................................................... 23 

Day two: ................................................................................................................................................... 23 

Day three: ................................................................................................................................................ 24 

Day four: .................................................................................................................................................. 24 

Day five .................................................................................................................................................... 25 

Children’s food preference and pedagogues as role‐models .......................................................................... 25 

Observation and interviews ........................................................................................................................ 25 

Role‐models ................................................................................................................................................. 26 

Food and meal policies .................................................................................................................................... 27 

Learning plan ................................................................................................................................................... 28 

Implementation of Sapere taste‐workshop in the learning plan ................................................................ 29 

Foodtales ......................................................................................................................................................... 30 

Physical Activity book ...................................................................................................................................... 31 

Litterateur .................................................................................................................................................... 32 

ListofkindergartensattendingthePeriscopestudies 

Name Code  Address on kindergarten 

Intervention‐ or control group 

Amount of children participating  

A  Intervention group  46 children 

B  

Control group (this kindergarten became an intervention kindergarten during the project)  

17 children 

C  

Control group (this kindergarten became an intervention kindergarten during the project) 

10 children 

D  Control group  27 children 

E  Control group  34 children 

F  

Control group (this kindergarten became an intervention kindergarten during the project) 

23 children 

G  Control group  20 children 

H  

Intervention (this kindergarten became a control  kindergarten during the project) 

21 children 

I   Control group  20 children 

J  

Intervention (this kindergarten became a control  kindergarten during the project) 

36 children 

K  Control group  19 children 

L  Intervention group  46 children 

M  

Intervention group (this kindergarten became a control  kindergarten during the project) 

22 children 

N  Intervention group   20 children 

EnrolmentsofkindergartensInDenmark14kindergartens,inthreemunicipalities,wereenrolledinthePeriscopeProject.Beforestartallkindergartenheadmistressandheadmasterswereapproachedbytheprojectstaff,acceptancesweregiventoparticipateandatimeschedulewasdevised.Afterthatallkindergartenreceivedaletterstopedagoguesandkitchenstaffaswellastoparentsexplainingabouttheproject.Furthermoretheparentsweregivenapermission‐letter(acceptanceforthechildtoparticipate).

652permission‐letterswerehandedoutinthe14kindergartensand360camebacksigned(55%).Outofthe360questionnairesthatweregiventotheparentsinthesummer2008,321werefilledoutandreturned(89%).

Outofthe360childrenbetweentheage3‐6yearsofage,thathadbeensignedupfortheproject,340childrenweremeasured(heightandweight)betweenthe5thofAugustand25thofAugust2008(94%).

InterventionandcontrolkindergartensOutofthe14kindergartensixwerechosentobeintervention‐kindergartensandeightascontrol‐kindergartens.Theinclusionwasmadebasedonaresearcherassessmentofresourcesavailable,involvementandcommitmentfromthekindergartenheadmistress/master,pedagoguesandparentboards.Anoralagreementweremadewiththeheadmistress/masteraboutparticipatingintheinterventionincludingprovidingresourcesandagreeingtotakesofaraspossiblethespecifiedinterventionaction.

Timeline(Nextpage)

Kindergarten A

Quest. preHeight & weight

FG ‐observation

PA ‐observation

Baseline FOODTaste‐

workshop Intervention 

FOODRolemodels food pref.

Foodtale   PA‐folder

Quest. pos

Kindergarten F Quest. preHeight & weight

Baseline FOOD Intervention 

FOODFoodtale   PA‐

folderQuest. pos

Kindergarten C Quest. preHeight & weight

Baseline FOOD Rolemodels food pref.

Foodtale   PA‐folder

Quest. pos

KindergartenB Quest. preHeight & weight

Baseline FOOD Foodtale   PA‐

folderQuest. pos

Kindergarten L Quest. preHeight & weight

FG ‐observation

Foodtale   PA‐folder

Quest. pos

Kindergarten N

Quest. preHeight & weight

Foodtale   PA‐folder

Quest. pos

Kindergarten D

Quest. preHeight & weight

Foodtale   PA‐folder

Quest. pos

Kindergarten E Quest. preHeight & weight

Quest. pos

Kindergarten G

Quest. preHeight & weight

Quest. pos

Kindergarten H

Quest. preHeight & weight

Quest. pos

Kindergarten I Quest. preHeight & weight

Quest. pos

Kindergarten J Quest. preHeight & weight

Quest. pos

Kindergarten K Quest. preHeight & weight

Quest. pos

Kindergarten M

Quest. preHeight & weight

Quest. pos

8  

Purposeofintervention‐ Increasingthediscoveryandknowledgeofhealthynevertastedfoodsbythe

children‐ Increasingtheexposuretothesespecificfoods‐ Improvingtheparentsempowermentinfoodandgeneraleducation‐ Trainingtheparentsandtheteachersineatinghabitmodificationtechniques‐ Reducingthejunkfoodexposureinkindergartenandfamilyenvironment(asactive

actiontakenbythewholecommunityineachofthesettings–childrenandteachersinkindergartenandchildrenandparentsinthefamilies)

‐ Trainingtheparentsoncheapandfastrecipes‐

Actioncomponents(toolsused):

1. Improvingtheestheticsoffoods(improvingtheappearanceofvegetablesandlegumesdishesmixingcolours,addingdecorations,etc)

2. Improvingandvaryingthewaysofcookingthesedislikedfoods3. Introducingthechildren’smostoftendislikedfoodsthroughshorttales4. TasteshopmedSapere5. Activityinvolvingthechildreninfoodprocessing6. Theacceptanceofkindergartenmeals(wastepercentage)

QuestionnairesQuestionnaireswereproposedtoparents,preandposintervention,togetinformationonparentsfeedingstyleandtheirchildren’slifestyle.Thetopicthatwerecoveredbythequestionnaire;Familyeatingstyle,child’sfoodpreferencesandphysicalactivity(PA)style,parentsknowledgeofbasicprincipleofnutrition,socialeconomicaldeterminantsinfoodchoosing,child’sTVuse,andself‐reportedparentsnutritionalstatus(heightandweight).

360 questionnaires were handed out in the summer 2008. 320 were filled out and returned (89%).

InMay–June2009thesecondroundofquestionnaireswerehandedoutinthe14kindergartens.Outofthe321fromthefirstroundonly145questionnaireswerefilledoutandreturned(45%).Thereasonforthesmallrespondsmightbeduetothefactthattheoldestchildrenhadletthekindergartentostartafour‐fivemonthpre‐schoolbeforeschoolinAugust,andalsothatthepedagoguesarerequiredtodomorepaper‐workduetodifferentchangesfromthemunicipality.Alsothechangesofheadmistressinthreekindergartenscreatedproblemswiththecooperationbetweentheresearchesandthekindergartens.Furthermorewewereinformedbythepedagoguesthat theparentshavesaidthatthequestionnairewastoolong,orthatthereweresomanydifferentprojectsgoingonatthesametime.

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Focusgroupinterviews

KindergartensasimportantarenaChildrenspendalargetimeoftheirwakinghoursindaycare(BUPLcapital).Thismeansthatchildreninaveryearlyageareincontactwithotheradultsthantheirparents.Thismakesdaycareaveryimportantarenaforchildren'sdevelopmentandlearning(Grønfeldt,2007),astheyexperiencea"doublesocialization”(Sølvhøj,etal1994,p.127).Thepresentageischaracterizedbyduality,leavingconflictingmovements,butasearchtofindaspaceforboththechildren'sself‐determinationandautonomyontheonehand,educatorsandactiveparticipationontheotherside(Broström2004).

Theaforementioneddevelopmentsetuprequirements to thepedagogues’didactic teachingskills (Broström, 2004). Didactic reflection and planning tools to justify the choices andforcingarenecessaryforthepedagoguestoreflectonwhethersomethingismoreimportantthan something else. The Danish principle of decentralization is maintained. The overallobjectiveofnoticeisthesameforallmunicipalities,butitisuptoeachmunicipalitytoclarifythevaluesandvisionsfortheeducationalwork,andthenforeachkindergartentointerpretanddevelopitsowncurriculum(ibidp.12).

The growing demands on institutions and pedagogues are reflected in the introduction ofannual and corporate plans in kindergartens and the educational curricula designed todescribeeducationalgoalsandpractices(Broström,2004).

InNovember2008twointervention‐kindergartenswerechosenforthefocusgroups(FG)interviews.Firstapilot‐projectwasperformedinanon‐Periscopekindergarten,‐bothchildrenandadultsFG.AfterwardsthefocusgroupswerecarriedoutaccordinglytothemethodsdescribedinPeriscope.DuetothefactthattheexpatiationsonthephysicalactivitywerenotmetduringthechildrenFG,itwasdecidedtovideotapethechildrenplayingintheirnaturalenvironmentinthekindergartenandanalyzestheresultsfromtheobservationstogetherwiththeresultsfromtheFG.InDecember2008,inoneoftheFGintervention‐kindergartensthechildrenparticipatedindrawingtheirfavoritegame.

StakeholdersDevelopmentofinterventionsaimedatimprovinglifestyleincludingPAandhealthyeatinginsettingssuchaskindergartenscannotbedevelopedalonewithstrictscientificallybasedandpotentiallynarrowsdomains.Insteadtheymustbeinformedbypractitioners’broadereverydaylifeperspective.

Parentsandkindergartenteachersareimportantstakeholdersinthelivesofchildren.Thus,thesestakeholdersseemobvioustoinvolveinthepresentproject.Moreover,byinvolvingthesestakeholdersimportantperspectivesofhowchildreneatandprefertheirmealsaswellastheirlevelofPAmightbeaccomplished.Theperspectiveonwhatmightlimitorencourage

10  

healthyeatingandPApatternsinchildren,isespeciallyimportantincurrentprojectasthechildreninvolvedhasalimitedcognitivedevelopment,duetotheiryoungage.

Thiswerethestartingpoint,forthefocusgroup(FG)interviewsforchildrenaswellasadults,tocapturekindergartenagechildrenandotherstakeholders(i.e.parentsandkindergartenstaff)viewsonpossibleinterventionstrategiestoeatingandPA.Thefocusgroupswereconductedfirstasapilot‐projectandthenintwokindergartenscontainingchildreninonegroupandparents,pedagogues,headofkindergarten,kitchenstaffinanotherinordertoobtainingbackgroundinformationonhealthbehaviorinthekindergartensaswellasinthefamilies.

TheinterviewswereconductedinconsistencywiththemethodologicalframeworkdevelopedbyMargheritaCaroliandfollowedtheguidelinesoutlinedinthePERISCOPEprotocol.However,itwasfoundthatrecruitmentofparticipantswereratherdifficult,duetoa)timerestrains,astheparticipantisrelativelyoccupiedintheirsparetime,andb)lackofresourcesinthekindergartens.Hence,thenumberofparticipantswasreduced,inordertoconducttheinterviewswithindeadline.

Twoseparateinterviewswithparentsandpedagogues(stakeholders)werecarriedout,regardingwhattheysawaslimitationsandpossibilitiesforthechildrentodevelophealthyeatinghabitsandimprovetheirmovementandPA.Afterseriousconsideration,itwasdecidednottoincludeparentsandpedagoguesinthesameinterview,duetoassumedconflictsofinterest.However,theinterviewguideusedinbothinterviewswasidentical.AstoopentheFGinterview,thestakeholderswereaskedtodiscusswhattheyunderstoodbytheterm‘healthhabits’,toensureanassociationregardingthespecifictopic.Thefollowingstageoftheinterviewwasdividedintotwomainphases,oneregardingthedietaryandonewiththephysicalactivityangle,respectively.Thetwomainphaseswerefurthermoredividedintotwosubphases,oneonthesubjectoflimitations(a)andoneonpossibility(b)todevelophealthyeatinghabitsaswellasimprovepatternsofPA.

ChildrenFGAstheaimoftheFG,weretogainknowledgeaboutchildren’sperceptiononfoodandmealsaswellasphysicalactivity,itweredecidedthataqualitativemethodwouldbemostappropriateforkindergartenagechildren.Withinthelasttwodecades,therehasbeenachangeregardingtheuseofchildrenasrespondentsinempiricalresearch(Andersen&Kjærulff,2003).Theyarenowconsideredasanimportantsourcetogaininformationonhowchildrenthemselvesareexperiencingtheworldinwhichtheylivein.Furthermore,byusingandconsideringchildrenasvalidsources,knowledgeonperspectivesthatmaynotbeobvioustoadultsmightbeaccomplished(Andersen&Kjærulff,2003).Thusrecognizestheparticipantsasexpertsoftheirworld,FG’shavetheadditionaladvantagesofminimizethepossibilityofthechildrenrespondingtopleasetheinterviewer,

11  

andalsoremovethepressurefromtheindividualchild(Heary&Hennessy,2002).Non‐leadingandopen‐endedquestions,whichlettogeneratediscussionamongthechildren,werestartedoutwithgeneralquestionsfollowedbymorespecificones.Duetothefactthatchildreninthisagecanhavedifficultiesinunderstandingabstractquestionsduetotheircognitivelevel,itwereemphasisedthatthequestionsweremodifiedinaccordancetothis.Furthermore,itwasdecidedtoseparatetheinterviewintotwo(oneforfoodandoneforPA),inordertokeeptheinterviewrelativelyshort,forthechildrennottolosefocusandconcentrationaswellasstructuretheFGpartaroundafewactivities,asthesewouldhelpfacilitatechildren’sparticipationinadiscussionanddialogue(Heary&Hennessy,2002).Theactivitiesincludedselectingpictures,dialoguebasedonpicturesandthechildren’sdrawingsofhealthyfoodandbestphysicalactivity,astogetavisualassociation.

ChildrenFGonFoodWhenthepicturesoffoodwerepresentedforthechildren,itwasobservedthatthechildrenhaddifferentknowledgeoffooditems.Thechildrenatonekindergartendidnothavethesameperceptionofthecontent,asthechildreninoneoftheothers.Thiswasespeciallyobservedduringthedebateaboutthecontentofthesaladdishinthepicture.Theydiscussedwhetherornotsaladwasaleaforadish;additionallytheyagreedonthattheyellowpieceinthesaladwascheese.Thechildreninonekindergartenidentifiedtheyellow“pieces”correctlyasmango.

Despitetherelativelyyoungageofthechildren,theystillhadaperceptionofhealthyandunhealthyfoods.Inthefinalphaseoftheinterviewthechildrenwereaskedtodrawsomefood,whichtheyconsideredashealthy.Almostallthechildrendrewdifferentfruit(mostlyapples)andryebread.Whenthechildrensubsequentlywereaskedwhytheyregardedtheitemsdrawnashealthy,theyexpressedthatitwasbecausetheylikedthem.LateroninoneoftheFGinterviewaboyexpressedthatunhealthyfoodisunhealthy,asitcontainssugar.Whenaskedwhytheythinkhealthyfoodishealthy,threechildren,respectivelyexpressedthathealthyfoodhelpsbuildmusclesandcontainvitamins.

Duringthefocusgroupinterviewswiththechildren,iswasrevealedthatthechildrenattendingthetwoPeriscopekindergartens(thathadalunchscheme),hadknowledgeofmorevariedfooditems,asthesechildreningeneralcouldmentionmoredifferentdishesandfooditems,comparedtothepilot‐kindergarten,(whichhadnolunchscheme)wherethechildrenshowedalimitedknowledge.Thisindicatesthathavingaplatformforpraxiscanpotentiallyleadtoincreasedlearningopportunities.Thismightbeanindicatorofthatalunchschemecontributestoamorecomfortableandadvancedrelationtonewfoodspresented,thanpackedlunches.Childpeerseatingtogetherwerebothbythestakeholdersandafewchildren,mentionedasafactor,whichcouldincreasetheappetitefortryingnewdishesorfoods.Surprisinglyitwasfoundthatpedagoguesseemtoplayamoreimportantroleasintermediariesinchildren’smealthankitchenstaff,whomdidnotseemtoplayaroleasactiveintermediaries.

12  

ChildrenFGonPABasedonthePAresultsfromtheFGitwasdecidedtouseyetanotheralternativemethodologytogetabetterunderstandingonthefactorrevolvingchildren’sphysicalactivitylevel.Researchersobservedthechildrenintheirnaturalsettingsinoneofthekindergartens(bothinsideandoutside)supportedbydigitalvideocamerastorecordtheobservations.Usingthismethoditwaspossibletocapturethemovementofthechildren,inacontextoftheirnaturalenvironmentinthekindergartenandthenuseitassupplementtotheinterviewsanddifferentdrawingsmadeearlier.UsingvideotapingasamethodwithinFG’andobservationresearchisrelativelynew,whichismainlyduetotechnicalreasons.Therefore,limitedliteratureistobefoundonhowtosystemise,analyseandpresentit(Rønholt,H.etal.2003).Themethodhasseveralforces,comparedwithtraditionalwrittennotetaking,giventhatithasthecapabilitytocapturemovement,talk,sounds,coloursandactions,asthesearecapturedintimeandspace.Thisgivestheinterpreteradvantageswhenreviewingthevideotapeanditisthereforepossibletointerpretonactionsnotvisibleandnotcapturedbytheeyeandmemory.Thusithastheabilitytogetclosertorealitythantraditionalmethods(ibid).However,whenaresearcherenters‘thefield’,itmustberecognizedthattheresearcherwillinfluencesitandherebyspoilsthenaturalenvironment(Kristiansen&Krogstrup,1999).

Theobservationswerecarriedoutatdifferenttimes,asitwasnecessarytofollowthekindergartensroutines.Inonekindergartenthechildrenspentthetimebetweenapprox7.30–10.30,outsideattheplayground.Postlunch,approximately12.30‐13thechildrenwereoutsideagainuntiltheafternoon.Thiswascommonroutine,regardlessoftheweather.Iftheweatherwasharsh,theyconsideredkeepingthechildreninside.Thechildrenattheotherkindergartenwereinsideinthemorningandusuallyoutsideafterlunchapproximatelyfrom12‐14.However,iftheweatherwasreallybad,theydecidedtostayinsideorspentlesstimeoutside.

Ingeneralallthechildrenwerequiteactive,butdifferencesbetweengenderswereobserved,astheboyswerethemostactive,whilethegirlsweremorecautiousandengagedinmorenon‐activeactivities,suchasdigginginthesandbox.Furthermore,itseemedlikethegirlsneededmoreinitiativesfromthekindergartensteachersthantheboys,toplaygames,whichdemandsthattheythemselveswerephysicalactive.However,whenanactivitywasinitiatedbythekindergartensteachersthechildrenparticipatedequally(e.g.dancingtomusic).Itwasobservedthatthechildrenwereusingtheentireplaygroundandallitsfacilitiesbothinatraditionalwaybutalsountraditional,e.g.walkinganddancingupwardsalargeslide.Moreover,thechildrenwereclimbingalmosteverywherepossible,ontheoutsideoftheclimbingframe,onthefencearoundthesoccercourtetc.Thiswasnotinterruptedbythekindergartenteachers.Duringtheobservationinsidethekindergartens,itwasobservedthatherethechildrentookfulladvantageofthespaceavailable.

13  

ChildrendrawingsessionBeforethedrawingsessionallofthechildrensatdownwithoneresearcherandtalkedabouthowtomoveoncebody.Thisweretogaininformationonthechildren’sknowledge,aswellasthechildren’sunderstandingofthewords;“moving”and“physicalactivity”.Todevelopawiderplatformforthechildrentotalkabout,theresearchershowedpicturesofphysicalactivechildren.Duringthefollowingdrawingsessionthechildrensatquietlynexttoeachother.Eventhoughthechildrenweretoldtodrawthatphysicalactivitythattheyenjoyedmost(aloneorwithothers)theywereinfluentbyeachother,andthereforesomeofthedrawingsareverymuchalikeandcannotbeincludedintheevaluation.

Editiontothedrawingseachchildwereinterviewindividually.Thesamequestionwereaskedandinthesameorder.Theinterviewswerecarriedoutbythesameresearcherthathadbeenconductingthedrawingsession.Thechildrenpreferredtoplaywithfriends,butafewindicatedtheimportantofsometimesbeingabletojustplaybythemselves.Majorityoftheboyspreferredtobephysicalactivewhenplaying.Noneofthechildrenthoughtthatthekindergartenneededanyothertoysorplayingequipment,besidewhatwasalreadythere.

StakeholdersGFonFoodTheparentssawthemselvesasthemostimportantrolemodelsinthelifeoftheirchildren,andoneparentstated,thatshethoughtparentsshouldbemoresupportiveabouttheworkofthekindergartensteachers,bycarryingontheinitiativesathome(e.g.letthechildrensetthetable,allowthemtoparticipateinthekitchen).Alltheparentssawthepedagoguesasrolemodels.Anaspectofthisisthatthepedagoguesareeatingthesamefoodasthechildrenduringthemeal,insteadofjustsupervisingandeatingtheirownfood.Thisperspectivewassecondedbythekindergartenteachers,astheyrecognisedtheirownimportance,bothasrolemodelsbutalsoasfacilitators,astheythoughtthatitwasnotonlyimportantthattheyatethesamefoodasthechildren,butfurthermorealsoencouragethemtotrynewfoods. Althoughthepedagoguesrecognizethemselvesasrolemodels,onepedagoguestatedthatshewouldnottakeresponsibilityforthechildren’snutrition.Inbothkindergartensitwasarulethatthechildrentriedtotastenewfoodsbeforerejectingthem.Ifthechildrendislikedthefoodaftertasting,itwasemphasisedbythepedagoguesnottocreateaconflictaboutit.

Theparentshadinadditionageneralconvictioninwhichthechildrenwouldbemorereluctanttotryandeatdifferentfoods,whenpresentedfortheminthekindergarten,asthissocialsettingisdifferentfromtheoneathome.Onepedagoguealsoexperienced,thatthechildreneithercouldencourageordiscourageeachothertotastenewfood,duetogrouprelationsandpeerpressure.Onetopicthatwasrepeatedamongtheparents,weretheincreasingnumberofchildrenpr.

14  

pedagogue,asthiscoulddecreaseactivities,suchasparticipationinthekitchen.Furthermore,theparentsbelievedthatitcouldalsoworsenthemealsituation,ifthepedagoguehadtosupervisealargernumberofchildren.

IntheFGtherewereanagreementamongtheparentsandthepedagoguesthathealthyeatingfocusedkindergartenlunchschemecouldcontributeinimprovingthedietaryhabitsofthechildren,asithasthepotentialtoofferavarietyofdishesandfoodsaswellasadifferentsettingthantheoneathome.Furthermore,inordertoincreaseownershipofthefoodprovidedinalunchscheme,boththeparentsandpedagoguesmentionedthatitwascentralthatthefoodwaspreparedinthekindergartenandnotdeliveredfromelsewhere.Theidealsituationwouldbeifthechildrencouldbeinvolvedinthecooking,asthiswouldfurtherincreaseownership. 

Thisparticularpartoftheinterventionwereseenbythestakeholdersasoneofthemostimportantstrategiesinimprovingchildren’sdietaryhabits,asitweresupposedthatthechildrenherebycouldincreasetheirknowledgeonhowfoodisprepared,andwhatthecomponentsofamealcanbe.Inaddition,theparentsassumedthatparticipationincookingwouldincreasethechild’smotivationforeatingitafterwards.

Allthekindergartenteachersagreedontoemphasizethatthechildrenhadknowledgeaboutwherefoodorigins,astheyseethisasaperspectiveofbeinghealthy.Inmostofthekindergartens,farmvisitswerearegularactivity.Inaddition,severalkindergartenshaddifferentherbsgrowinginthegardenandonekindergartenhadtheirownkitchengardenatoneofthefarmswheretheygrewtheirownvegetables,whichwereusedinthekindergartenkitchenafterharvesting.

StakeholdersFGonPAThelevelofhowmuchparentsthemselvesregardedtheirowninvolvementandresponsibilityonthesubjectofPAandmovementwerediverse.However,someparentsdidseeitasimportant,tosupportthehealthimprovingapproachesinthekindergarten,forinstancebylettingthechildrenwalkthedistancefromthehometothekindergarten,insteadofbeingdriven.Thisisinlinewiththeresultfromthequestionnairewhere37%ofthechildreneitherwalkorbike(themselves)tokindergartenand45%homeagain.(Unfortunatelyitwasnotpossibletocomparetheresultsfromthepreviousquestionnaire,becauselasttimeitwasnotstatedcleanenoughwhetheritwasthechildortheparentridingthebike).Buteventhoughonly41%livesfurtherawaythan1kilometre,50%aredrivingtokindergartenbycarand42%homefromkindergarten.

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Reportoffoodinterventionmenuandtasteworkshopresultinkindergarten

FOODBaselinemenuFromJanuary2009–February2009fourintervention‐kindergartensparticipatedinthefood‐intervention(A,B,CandF).Abaselinemenusfromallfourkindergartenswerecollected(foranalyzingthenutritionandquantity)andineachkindergartenobservationsweremadeforfivedayson;howthefoodweremade,howthefoodwerepresented,howthechildrenate(physically/logistic),howmuchthechildrenateandhowmuchwerewasted(664mealsintotal).

Twoofthekindergartensservedbuffet(therewasalwaysbreadandcoldcutservedtogetherwiththewarmdishincasethechildrendidnotlikethedishoftheday).Theothertwokindergartensservedonlyonetypeoffoodperday.

Beforevisitingthekindergartenslettersweresenttotheheadmistress/headmasterexplainingtheimportantthateverythingshouldbeasnormalaspossibleandthatwewouldonlyobservedthemakingofthefoodandthelunchsituationitself.Nointerferingwouldbemade.Aletterofinformationwashungupontheparent‐informationboard,sotheycouldseewhentheresearcheswouldbeintheirchild’skindergarten,andespeciallywhattheywouldbeobserving.

FOODInterventionmenuInMarch2009,afterthefourweeksofobservationinfourintervention‐kindergartens,alldata’swerekeyedinandanalyzed.Accordinglytotheresultsthekindergartenfoodhadalreadyhighstandards.ThestandardsoftheNNR(NordicNutritionRecommendation)weremade.

ThebasisoftheDanishinterventionwerechosentoasfollowed;Morelegumes,morevariesvegetable(carrotswerethemostpopularvegetable),moredark‐greenvegetable,lessbreadatlunchtime,moreoilinfoodandlessbutteronthebreadandmoremilk.Fivelunchrecipesandfourafternoonsnackrecipeswerecreatedspecificallyfortheinterventioncontainingthefoodmentionedabove.Outofthefourkindergartens,twowerechosentoparticipateinthefood‐intervention;onebuffet‐kindergartenandonekindergartenwheretheyservedonetypeoffood(AandF).Lettersweresenttothetwokindergartenheadmistress,explainingthemenus,theimportantofcooperation,notjustfromthekitchenstaffandbutalsothepedagoguesduringtheinterventionweek.Sincethepedagogueseatthesamefoodasthechildrenandwiththechildren(pedagogicmeal),itwasimportantthattheyknewthebackgroundforthechangesofthefoodandthattheyunderstoodtheirroleasbeingrole‐modelsforthechildren.

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Themenusweresentoutbeforetheintervention,notjustforthekindergartenstafftobeabletogettheingredients,butalsoforthemthegettoknowtherecopiesandtoworkoutatimeframeforthemakingofthefood(372mealsintotal).Aposterwerehungupontheparentsinformationboardwithmenus,explanationsforthedifferentingredientsandthankingforthecooperationduringtheweekstheprojecthadbeengoingonintheirchild’skindergarten.

InterventionmenuresultsThefindingfromtheobservation‐baseline(the4kindergartenx5days)showedthatthechildrenwereeatinglotsofcarbohydrates,majorlyryebreadandhomemadewhite/wholegrainbread.Thetotalamountofcerealproducts,wereduringbaseline168gprchildprweekand190gduringintervention,outofwhich116gwasbreadduringbaselineand145gduringintervention.Ingeneraltheyeatmanyvegetable,butthesourceisverylimited.Carrots,cutoutassmallsticks,arethemainvegetablesource.Duringbaselinethechildrenhad72gofvegetableaweekandduringinterventionthiswasincreasedtill115g.Intwoofthekindergartensonepieceoffruitprchildapproximatelyeverydayisbeingprovidedbythekindergarten,inonekindergarten½piecesoffruitprchildisprovidedandinthefourthkindergartenthechildrenbringonepieceoffruiteverydayforthemselves.Inaveragethechildrenhad77goffruitaweek(mostlyapple,banana,clementine,andpear)duringbaselineand88gduringintervention.

Onefindingwasverysurprisingly.Especiallyinonekindergarten(kitchenstaff)wasafraidofusingfat(butter,oilandfattydairyproducts).Thereasonforthismightpartlybefoundinthepublicawarenessonchildren’singeneralfattydiet.Butalso,asitwasobserved,becauseofthepedagoguesinterferinginthemenu,duetothefactthatbecausethepedagogueseatthe

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samefoodasandwiththechildren(pedagogicmeal),theyareverymuchawareofthefatlevelinthefood.Thiswasespeciallynotedwhenthetwointerventionkindergartenwerepresentedthenewmenu.Severalcommentweremadefromthefemalepedagoguesthatifthatkindoffoodwerepresentedinthekindergartentheycouldgainweightandduetotheuseoflegumesandmorewholegrainproductscommentsweremadebythemalestaff.

Belowisafigurethatshowsthedifferentintakeinthetwointerventionkindergarten.Especiallyoneofthekindergartensdidnotconsumethequantitiesthatwhereexpected.Thereasonforthedifferentmightbefoundinthefactthatonekindergartenwasa“buffet‐kindergarten”(ryebreadwithsomedifferentcoldcutwasalwaysservedbesidethemaindish)whiletheotherkindergartenonlyservedonedishforlunch.Duringtheinterventiononlyonedishwasserved.Thiswasaverybigprobleminonekindergarten,becausetheywereverymuchusetohavingachoice.

Thefigurebelowshowstheaverageintake(ingram)perchildovertheweekoftheintervention:

ThevegetableintakefromkindergartenF,weremostlyconsumedduringthemorningsnackthroughcarrotsticksandthebreadintakeduringtheafternoonsnack.Itwasobservedthatthechildrenwasuseto,andenjoyedverymuchcomingtothekitchendeskbetween9‐10andtalkwiththekitchenstaffwhiletakingthecarrotsfromabigbowl(Thecarrotslaidinwaterandwastakenoutbythechildrenwithapairoftongs).

Somechildren(andpedagogues)refusedtoeatanythingforlunch(andthentheyatealotduringafternoonsnack).Especiallythepedagoguesreactionwassurprisingly,sincetheyknewabouttheprojectandknewthatanewmenuweredevelopedespeciallyforthis

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intervention(meaningmorefat,morelegumesandmoredifferentvegetable,particularlydarkgreenvegetable).Onethesecondday,thekindergartenwasapproachandameetingwasheldthenextdaytoinformthepedagoguesthattheyneededtokeeptheirpersonalopinionstothemselvesandinsteadactasanintermediarybetweenthekitchenandthechildrenandbecomearolemodelforthechildren.Duringthelasttwodaysinthatkindergartenthepedagogueswereverymoreopenandpositivetowardsthenewfood.Thiswasobservedbytheresearchespresentduringthelunches.Eventhoughthechildrenwerestillreluctanttotrythenewfood,thepedagoguesnowtriedinapositivewaytomakethechildrenjusttastethedifferentfood.Thedifferentattitudefromthepedagoguesgavethechildrenthecouragetotry.Stilltherewasnoconversationatthetableaboutthefoodtherewasserved.Alltheinformationwasonlygivenbythekitchenstaffwhenthechildrenaskedthemaboutthefood.

InkindergartenA,aconversationwasobservedbytheresearcher.Toboyswerediscussingthetasteinoneoftheshreddedvegetabledishes(shreddedcarrots,beetrootapples,whitecabbage,‐andvanilla).OneboythoughtittastedlikevanillaicecreamandtheotherthoughtittastedlikeaDanishsummerdishwithbuttermilk,eggandvanilla.Noneoftheboyscouldidentifythevanillasugarasbeingthesubstancethebothrecognised,buttheybothknewthattheotheronewastakingabout(bothboyshadbeenintheSaperefoodworkshopafewweeksbeforethisconversationtookplace).Theconversationbetweenthetwostartedamoreopenconversationbetweenmorechildren.

Thefigureclearlyshowsthatbread,pastaandricearethechildrenpreferfoodgroupaccordinglytotheparents.Withinthiscategorymostchildrenpreferspasta,thenbreadandlastrice.Thefigurealsoshowsthatthesecondpopularfoodgroupisfruit.Legumes(fresh

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anddried),isthefoodgroup,thatoftenisdeselected.Fishdeselectedmoreoftenthanitisselected,whilethefoodgroupmilkandcheeseareselectedanddeselectedequally.Inthelastcategory,cheeseisbeingdeselectedmoreoftenthanmilk.

Eventhoughpotatoesarenotafoodchose,thatthechildrenprioritiesanddeselectmoreoftenthanselect,74%oftheparentsstillservethem1‐3timesaweek.

50%oftheparentsdonotservelegumes,whichisinlinewiththechildren’schose,asthefoodgrouptheydeselectmostly.

Fisharenotbeingservedforhalfthechildrenandfortheotherhalfitisserved1‐3timesaweek.Itshouldbenotedthatifthisresultiscomparedwiththechildren’sdeselectoffish,whichisonly10%,whenitistheparentslacktoservefish,whatisthereasonforthechildren’sminorintakeandnotthechildren’sownpreferences.

TasteworkshopAsinitiallydescribed,overweightandobesityisanincreasingproblem.Howepidemiologistspreviouslydealtwiththedeficiencydiseases,societytodayfightanaffluentsocietywithlifestyle‐relateddiseases(Nielsen2008).Whenfoodissofreelyavailable,leaveourtastepreference,‐whicheitherspeakfororagainstcertainfoods,animportantroleinourdailyfoodchoices(Wardleetal2001,s.217).Taste,asdeterminantofchoicebetweendifferentavailablefooditems,isnotsomethingnew.Tastebudshaveformillenniahelpedtochoosebetweendifferentavailablefood,becausethetastehasbeenanimportanttoolinsurvival(Stenderetal,2005p.83).Modernsensoryresearchoperateswithfivebasictastes,aspeoplearebelievedtobeabletodistinguishbetween.Thesearesweet,salty,sour,bitterandumami(Nielsenetal2008).

Children'sdietismainlycharacterizedbytheirsugarandfat.Thereasonbeing,whyit’sthesweetandrichlifestylethatappealstous(andsopositivelychargedexpression),mightbeconnectedwiththefact,thatwehaveapredilectionfortheverysweetandfattening.Fromearlydayswhenmanwentforthesweettaste,(asweknowitfromfruit),theywerecapableofsimultaneouslysteeringroundthesourandbitter,whichcouldindicatethattheywererottenorpoisonousfood(Beauchampetal2009,p.S2).

Thatfoodshouldhavesomerecognitionvalueforthechildren,doesnotmeanthatitmustbetrivialandshouldonlycoverthemostbasicfood(Léon2006).Ifthebuilt‐inpreferenceforsweetandfattyfoodsshouldbenuancedandseeksdiversedietarypreferences,thisrequirespositiveexperienceswithpreciselybalancedmeals.Whenchildrenhavealittleexperiencetoframetoeatfrom,onemustassumethattheydeselectavarietyoffoodsanddishes(ibid.).Theavailabilityofhealthyfoodisthecornerstoneinthedevelopmentofhealthydietarypreferences.

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StudiesmadebyJaneWardle,DirectorforcancerresearchatUKHealthBehaviorUnit,DepartmentofEpidemiologyandPublicHealth,Englandhasshownthatparents'ownintakeoffruitandvegetables,aswellastheircontroloftheirchildren'sintake,hasanoverallimpactonchildren'sfruitandvegetableintake(Wardleetal2005,s.227‐230).Parentsactingrolemodelisanimportantfactor,sinceasmallornon‐consumptionoffruitsandvegetablesbythemhasanegativeeffectonchildren'sintakeoffruitandvegetables(ibid.).Inaddition,studiesshowthatparents,whoeatlittlefruitandvegetables,aremorereluctanttoforcetheirchildrentoeat(ibid.).Themoreparentspushtheirchildrentoeat(thattheydonoteatthemselves),thelowertheaverageintakeoffruitandvegetableswillbecome(ibid.).Furthermore,thereisariskthatthechilddevelopsanaversiontocertainfoods.Havethechildfirstanaversiontoaparticularfood,thisisdifficultto"cure"andarejectionofthatfoodmayconsistofmanyyears(Wardleetal2008,s.S16),evenafterthechildasanadult,becomesawarethattheaversionswereduetocircumstancessurroundingthefoodandnottheactualfood. Children'srejectionofcertainfoodscanresultintheparents(duetoconcernforchildren'soverallenergyintake)givesinandonlyservesthefoodthatthechildrenprefer.Bycontinuallyavoidingaspecificfood,theaversionenhances(Wardleetal2008,s.S17).

SaperemethodInFebruary2009oneintervention‐kindergarten(A)werechosentoparticipateinaTasteWorkshopbasedontheSapere‐methodbyJacquesPuisais.Foraweekthechildrenandthepedagogues,smelled,saw,tastedandmadefood.Theyusedtheirbodies,wentontreasurehunts,theytalkedaboutfoodandtheplayedfood‐games.

ThepurposewithSaperemethod:•Toteachhissensesandhistastetoknow•Todeveloptheirabilitiestoexpressthemselvesverbally•Todaretrynewfoodsanddishes•Tohavegreatervariationintheeating•Tocreateaconsciousconsumer

Duetolimitofresources,wechoseonekindergartenforthefoodworkshop.Thetimeframewerefivedaysandtheparticipantswerethechildreninsmallgroup,twopedagogues,twokitchenstaffandtworesearches.

SincetheoriginalmethodaswellastheSwedishmethodhavenotbeentriedonsmallerchildrenthan11‐12yearsold,itwasnecessarytomakedifferentadjustmentsduetothekindergartenchildren’scognitiveagelevel.Furthermoreaboardsense‐gamewasinventedbytworesearchassistants.Informationlettersweresenttotheheadmistressandthepedagogues.Afterthatmeetingsweresetupbetweentheresearches,headmistress,kitchenstaffandthetwopedagoguesincharge,wheredetailsofthetasteworkshopwereexplainedandatimeframeweresetup.Afterthateachparentreceivedaletterwithbackgroundinformationontheimportantofrecognizingsweet,salty,sourandbittertastetodevelopa

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potentialfoodcourageandthattheunfamiliarityofsomefoodcouldlettofoodaversionthatwillfollowthechildrenforaverylongtime.

ProtocolforSapereTasteworkshopBelowasummaryontheactivities,themethodandtheresults:

Dayone:Introducingfourofthefivebasictastes;sweet,sour,saltandbitteraswellascolour,smellandtexture.

Everythingwasplacedinsmallglassbowlssothechildrencouldseecolourandtexture.Afterthesessionitwasdiscussedtheimpotentsofnexttimetohavethewholefruitnexttothebowl,forthechildrentorecognizeit,notjustbeforetastingit,butalsoforlateron,iftheysawitinashop.

Firsttheytastedsomethingsweet.Thiswaschosen,duetothefactthatmostchildrenhaveapreferencetothesweettaste.Theytastedacaciahoneyandartificialsweetener.Allthechildrenwereveryeagertotryandtheylikedthehoneyverymuch.Allhadtastedhoneybefore,butnotallacaciahoney,andforthose,itwasmoredifficultforthemtoguessthatitwashoneybeforeactuallytastingit.Beforethechildrentastedtheartificialsweetener,theywereaskediftheythoughtthatallsweetthingstastedgood.Theyallthoughtso,butaftertastingtheartificialsweetener,theychangedtheyminds.Somethoughtthatittastedsourandothersthoughtitwastoosweet.Theycouldnotunderstandthatitcouldbeusedasasubstituteforsugar.

Afterthatthechildrentastedsomethingsour;limeandGrannySmithapples.Whenthechildrensmelledit,mostofthemcouldnotsmellanything,butsomesaidthatitsmelledsour.Onlyoneboyguesseditwaslime,theothersthoughtitwaslemon.Allthechildrenlikedtheapplesbetterthatthelime.

Thethirdtastewasbitter;Ruculalettuce,grapefruitandradish.Surprisinglymostofthechildrenlikedthelettuce.Thechildrentookthegrapefruitasbeingorange,butwhentheytastedit,theyknewthatitwasnot.Onlyafewgirlsreallylikedthetaste.Allthechildrenlikedtheradish,eventhoughsomeofthemthoughtitwasstrong.

Thelasttastethechildrentastedwassalt.Thereasonforleavingsaltasthelasttastewasduetothefact,thatmanychildrenlikethesaltytaste(chips)andthatwouldendthesessionwithatastetheywerefamiliarwithandthattheyliked.Theytastedsaltbiscuitsandsaltypeanuts.Notsurprisinglyallthechildrenlikedboththebiscuitsaswellasthepeanuts.

Daytwo:ThechildrentastebudswerenowchallengewhilethebasictastewasnowmixtwoandtwotogetherAndtheythereforehadtotryandrecognizethemfromeachother.Thedifferentmixedtasteswerelimejuiceandacaciahoney,grapefruitjuiceonsmallpiecesofGranny

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Smithapples,saltbiscuitswithradish,saltbiscuitswithstrawberryjamandgrapefruitwithsugar.

Limejuiceandacaciahoney.Thechildrencouldeasilytastethattherewassomethingsweetinthejuice,buttheyhadproblemsfindingoutthatitwashoney.

GrapefruitjuiceonsmallpiecesofGrannySmithapples.Everyonethoughtthatittastedbetternowthanwhenthegrapefruitwasonitsown.Thesourapplehadtakenalittlebitofthebittertasteaway.

Saltbiscuitswithradish.Allthechildrenthoughtthattheradishnowtastedsalty,butalsoalittlebitstronger.

Saltbiscuitswithstrawberryjam.Someofthechildrensaidthatthejamtasteofsalt.Theycanrecognizethetwodifferenttastes,buttheycandistinguishthemfromoneanother.

Grapefruitwithsugar.Thisisthemostdifficultforthechildrentorecognize.Someofthemsaidittastedsourandsomesaidbitter,buttheyknewthattherewasanothertaste,buttheyjustcouldnotdeterminewhatthesecondtastewas.

Daythree:Thiswasaphysicalday.Thechildrenweredividedintogroupstogotreasurehunting.Buttogettothetreasuretheymustpastseveralpost,wheretheyeitherhadtoanswerquestionsordosomethingphysically.Thequestionasked,wereaboutthedifferentfruittreesandberrybushes,growinginthekindergarten.Tohelpthechildrenpicturewereshown.This,becausenotallthetreesandbusheswerecarryingflowers/fruit,atthepresenttime.Thephysicalactivitywasclimbingupintheplaytower,godowntheslide,kickaballintoagoal.Allthechildrenlikedtheactivityandespeciallythetreasure,whichwasacarrot/squashmuffin,sweetenedwithraisins.

Dayfour:Anewboardgamewasinventedandpilottestedduringtheintervention.

Itwasdesignedasanordinaryboardgamewherechildrentookturnswithadiceandmovetheirgamepiecethenumberoffieldsdice.Someofthefieldsarecoloredandeachcolorbelongstoacategory.Thereare3categories,senses,foodandmovement.Foreachcategory,therearequestionsaboutfoodandsenses.Besidesthethreecategoriestherearephysicalcardsthatdescribedanactivityforthechildforperform.Thisgivesthechildrentheopportunitytomovearoundandshowtheirmotorskills. Thechildrenandthepedagogueswasveryexcitingandthoughtitwasfuntoplaythegame,andfurthermorethepedagoguesthoughtitwasnicethattheysawawholenewsideofthechildren.

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DayfiveThelastdaythechildrenbakedbreadwiththestakeholdersinthekitchen.Allthechildrenwereveryeagertoparticipate.Duetocolourandsmell,itwaschosen,thattheycouldmakefoccaciawithredpeppers,squashandfreshlychoppedherbs.Everyoneparticipatedinmakingthebread,choppingtheherbs,peppersandsquash.Butmostimportantly,thechildrentookgreatprideinmakingthebreadthatallthechildreninthekindergartenshouldeatintheafternoon.

Children’sfoodpreferenceandpedagoguesasrole‐modelsBothmealandmeal‐patternhasundergonearadicaltransformation.Theavailabilityofmanufactureandsemi‐manufacturefoodincreasesthecompositionscomplexity.Atthesametimewelosehouseholdknowledge,insightandskillsincooking(Holmetal1997,p.41).Thelackofinvolvementofchildrenalsoincreasestheriskthattheremaininginformationislostfromonegenerationtothenext(DVFA2009,kap.5).Thiscanleadtochildrenbeing"culinaryilliterateswherefoodissomewhatabstract,theymayfeelestrangedfrom"(ibid.).“Children´sfoodpreferencesareimportantdeterminantsoftheirfoodintakeandassuchareofinteresttoresearchersandpractitionersalike.”–(Wardleetal2008s.S18).Theknowledgeoffoodisthebaseforitsacceptance.Thepriorirefuseofaspecificfood,especiallyinpediatricage,isgenerallydeterminedbythelackofknowledgeandfamiliaritywiththatparticularlyfood.Toinitiatechildrentoacompleteknowledgeofdifferentfoodmeanstolaythefoundationofafutureacceptance.

ObservationandinterviewsInApril2009,afterthefoodinterventiontwoofthefourfood‐interventionkindergartens(AandC)werechosenforafoodpreferenceanalyzes,usingvideo‐observationduringthelunchsituationandinterviews.Theobservationstookplaceoverfourdays,twoineachofthetwokindergartensandonedaywheretheinterviewswereconducted.Fivepedagogueswereinterviewedintotal,threefromthebaselinekindergartenandtwofromtheother.Beforehandallparentshadreceivedaninformationletter,sotheyknewthattheirchildrenwouldbeobservedandvideotapedduringthelunchsituation.Thepedagoguesweretold,priortheobservationthattheresearcheswouldobservethelunchsituationtwodaysinaroadandthattheycouldbeinterviewoneononeafewdayslater.Thequestionsaskedduringtheinterviewswereaboutwhetherornotthepedagoguessawthemselvesasrolemodelsforthechildrenduringthemealsituation,whethertheyhadorhadhadaninfluenceontheFood&MealPolicyinthekindergartenandiftheybelievedthatthepolicyhadaneffectintheirbehaviorduringthemealsituation.Thereasonbeingforchoosingthetwodifferentkindergartenswastoobserveanydifferentinthepedagoguesbehaviortowardsthefoodandthefoodsituationduringlunch,knowingthatoneofthekindergartenhadparticipatedinthenewmenuinterventionandtheother“only”asabaselinekindergarten.

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Role‐modelsGoodrolemodelsareimportantforreductionrejections(Wardleetal2003a,s.342;Wardleetal2008,s.S16‐18),duetotworeasons:First,observingotherswhoeatfood(beingparents,educators,peers,etc.),canbeadirectcauseofdietaryimitation.Thisisalsocalled"modeling".Secondly,thisintake(exposure)willinitselfpromotethepreference,asexplainedabove.Thecommonmealhasabuilt‐inteachingfunctionthroughbeingwithothers.Socialintercourseprovidesanopportunitytooversteponesboundariesandindividualtastepreferences.

Thefigureshowsthatmostparentsneverusefoodasanemotionalstabilizer,exceptifthechildissad.Hereonly39%statesthattheydonotusefoodasanemotionalstabilizer.Butwhen“never”and“rarely”arecombined,thedistancenarrowsdownandthetotalscoreofparentsneverorrarelyusingfoodasanemotionalstabilizerinsituationswherethechildrenareunhappy,naughty,hurt,moodyorangryisthen94%.

45%wouldneverpromiseadesserttomakethechildeattheirdinner,while35%rarelywouldusethismethod.Withthetotalamountof82%itisconcludedthatparentsuseonekindoffood(dessert)tomakethechildeatanotherkindoffood(dinner),butnotasarewardorpunishmentforgood/badbehavior.

Observationsduringlunch(4weeksduringbaseline,2weeksduringinterventionand2dayswithfocusonthepedagoguesandtheroleasmodeling)showedthatchildrenwereinterestedin,forexamplevegetabledish,ifthepedagogueofferedthefood,ateitthemselvesand

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physicallypastedthedishtothechildren.Thepedagogueswereveryconsciousonsocializationissues,suchas;thattheyatethefood,thatwereservedandthattheyshowedaninterestinthefood.Conversely,therewasnoreflectiononhowthefoodwasprocessed.Forexample,pedagoguessatsqueezedinbetweenorbehindthechildren;eatingwiththeplatesontheirlaps;didnotbegineatingbeforelongafterthechildrenhadbegun;gavecommonmessageswhilethefoodwaswarmatthetable;talkingonthephoneduringthemeal;leftthetablewhilethechildrenwerestilleatingandgaveconfusinginformationonhowandwhetherthechildrencouldleavethetablewhentheywerefinished,etc.Focusontherolemodelfunctionwasinotherwordslimited,tothefooditself,butdidnotincludetheframeofthemeal.

Theaboveobservationsaresignificant,becausethereisastrongcorrelationbetweendietarypreferencesandthecontextofwhichthefoodisincludedin(Léon2006).Theemotionalreactiontofood,rangingfromrejectiontoindifferenceorpleasure,associatedwiththeexperienceofagiventypeoffood,isverymuchsomethingpersonal(ibid.).Cultureandthepeoplethechildrenaresurroundedby,arethereforeimportantfactorsaccordingtowhichfoodthechildprefers,becauseitisthesurroundings,whatintroducefoodtothechild(ibid.).

Inseveralsociologicalstudies,mealresponsiblewomensays,thatitisdifficulttoprioritizenutritionineverydaycooking.Onegoalistoeconomizebothtimeandfinancialresourcesandcreateahealthymealforthefamily.Andanothergoalistodoit,inawaythatsecuredthefamily'srecognitionandgratitude,whichmeansaconfirmationofthelovingrelationshipswithinthefamily(Holm2003,p.23).Desiretobenefitthenutritionispresent,butisoffendrefrainfromthisinordernottocreateconflicts.Thussaysoneinterviewee(mealresponsiblewoman):"Igivethemwhattheylove,insteadofwhat'sgood"(Holm2003,p.23‐24).

Itisthereforenotonlytheenjoymentoffoodthereisatstake,butalsoa"symbolicformoffoodbecausethecarefullypreparedfoodexpressescareforthemthefoodismadefor"(Holmetal1999,58).Theaboveisconfirmedinthestudythat“DanishDiets”publishedbytheFoodDirectorate.Thisfeatured73%offamilieswithchildrenthattheessentialschoiceofmealswerethatthefamilylikedthefood.Theexamplesshowthatpreviouslyelucidatedthatthefoodfirstandforemostembeddedinculturally‐rootednotionsofwhat“real”foodis.Toservethewrong(butnutritious)rightfood,couldresultintheguiltyconscienceofthemealresponsible(Jensen2003,p.77).

FoodandmealpoliciesFoodandmealpolicies(FMP)isasetofcommongoalsonfoodandmeals.Thepolicycoversbothwhatiseaten,andtheframeworkforthemeal,suchasfurnishings,location,incl.timeadayanditslength.Thepurposeofafoodandmealpolicyistomakedemandsandattitudestowardsfoodandmealsvisible(DVFA2008).Studieshavehighlightedthatfoodandfoodpoliciesareameanstoclarifymutualexpectations,bothinternally(betweenmanager,kitchenstaffandpedagogues)andexternally(betweenparentsandkindergarten)andcanprovideaframeworkforanchoring,continued

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dialogueandexchangeofexperience(Lissau2006).Intheinterviewsitisthereforeasked,howthepedagoguesexperiencethefoodandmealpolicyinKindergarten.Theseshowedthatpedagoguesagreedthat,thefoodaswellasthemealsisanimportantpartoftheinstitution'slife.Mealsforthekindergarteninwhichtheinterviewstookplaceisrelativelynew,sinceitwasfirstintroducedfor1½yearsago.Thedecisiontointroducecanteeninkindergartenwasbackedupnotonlyofemployees,butalsooftheveryactiveparentscommittee.NoneofthethreepedagoguesthatwereinterviewedhadbeenintroducedtotheMMPandhadnotbeenpartofthedevelopment.TheknowledgeofthecontentsoftheMMPwaslimitedtoecology,variabilityandthatthemenuwasdividedintoweekday.ForthesamereasonallthreepedagoguessaythatthecurrentMMPplaynoroleintheeducationalwork.  ManagementhasshownnointerestinfollowinguponpolicyandtwopedagogueshighlightedthattheyfeelalienatedfromtheMMP,becausetheyhavenotbeenpartofthecontext.Throughouttheinterviewsandobservation,itwasclearthatthepedagogueshadverydifferentperceptionsoftheirrolesinthemealsituation.Onepedagoguedidnotapproveofrulesandbelievedlunchfirstandforemostshouldbeafunexperience.Anotherpedagoguewasverycarefultoteachthechildrensocialskills,suchastablemanners.Athirdpedagoguedidnotwanttointerfereandbelievedthatthelunch‐brakeneededtobeanactivitywherethechildrenhad“timeof”fromrules,duetothefactthatthereweresomanyotherstructuredactivitiesthoughtouttheday.Allthreepedagoguesagreedontheneedofguidelinestoestablishaframeworkaroundthemealsituationandthatthiswouldprovidefocusandaframeworkfordailyimplementation.

Thepedagoguesseemeddedicated,butlackedvisionandconcreteactionexperienceonwhatwouldstrengthenthechildren’sfoodandeatingknowledgeandhabits.Itisthereforeconsideredtorequireanefforttostrengthenpedagogues’competencetoact,ifmealpedagogyistohaveasolidfoundationongoodfoodmannersandculture,asaprimetarget.

LearningplanCurriculainkindergartensThelearningplanisapedagogictoolthateverykindergartenhavetowritedownasguidelineforthetopicsthekindergartenhaschosentoworkwithanditmustincludesixcompulsorysubjects,butcaninaddition,addothertopics‐dependingonwhatisdesirableandappropriateineachkindergarten.Resultsfromthetasteworkshopandtherole‐modelsobservationshavebeenincludedinthelearningplanbelow: 

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ImplementationofSaperetaste‐workshopinthelearningplan

1. Personaldevelopment.Childrenmustbeableto:•Takepartinimportantsocialandculturalexperiences•Unfoldasstrongandversatileindividuals•ExperiencethemselvesasvaluableparticipantsinasocialandculturalcommunityThroughplay,childrencanlearntheculturalcommunitywhichsurroundscookingandeatingfoodtogether.Inadditiontheymaybemoreversatileintheirfoodlanguage‐andpreferences,andfeelpridewhentheyhavetastedsomethingtheymaynothavedaredbefore.

2. SocialskillsChildrenmust:•Berecognizesandrespects•Experiencethecomfortandconfidenceintheirrelationtobothchildrenandadults•BeinvolvedandencouragedtobecomeactiveparticipantsindemocraticprocessesLearningaboutfoodandhealthyeatinghabitsis,likelearningingeneral,asocialinteraction.Furthermoreitisasocialprocesstoeatwithothers,cooking,etc.

3. Languagedevelopment:Childrenmust:•Beabletodeveloptheirlanguageinalldailyactivities•Bechallengertolinguisticactivity•Havesupporttodeveloptheircuriosityforthecharactersandsymbols•HaveaccesstocommunicationtoolsOneobjectiveofSapereistodevelopchildren'slanguage,sotheyarebetterabletoverbalizetheirexperiencesandfeelingsaboutfood‐andherebydeveloplanguageskillsinotherareasalso

4. BodyandMovement:Childrenmust:•Experiencethejoyoftheirbodiesandbybeinginmotion•Beabletostrengthentheirphysicalhealth•Beabletoactivelyexploreandassimilatetheworldthroughallsenses•Knowthebodyfunctionsanddeveloprespectforselfandothers'physicalityBodyandfoodbelongtogether,andchildrenalsolearnbestwhentheyareinmotion.

5. Natureandnaturalphenomena:Childrenshouldbeallowed:

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•Toexperiencethejoyofbeinginnatureanddeveloprespectfornatureandenvironment•Tolearnasnaturalspacesforplayandimagination•Togetdifferentexperienceswithnatureandnaturalphenomena,andexperiencenatureasaspaceforexplorationoftheworldFoodcomesfromnature,notfromthesupermarketandtherefrigeratorathome.Givingchildrenfoodexperiencesinthewild:pickingfruitsandberries,bakebreadoverthefire,makeasmallvegetablegardenwheretheycanseethevegetablessproutandgrowandharvestthemthemselves.

6. Culturalexpressionsandvalues:Childrenmust:•Meetadultswhocommunicateculturalandsupportsthemtoexperiencevariousformsofexpression•Haveaccesstomaterials,toolsandmodernmedia•ParticipateinlocalculturaltraditionsandartisticofferFoodiscultureandithasgreatculturaltradition.Childrencanlearnabouttheirown,aswellasotherculturalthroughfood

Inadditiontheabovealldaycarecentersmustofferchildrenahealthylunchmeallastfrom1stofJanuary2010.(Itispossibletogetdispensationtill1stofJanuary2011).MealsmustbehealthyandliveuptotheofficialrecommendationsoftheFoodAgencysets.Lawonthelunchmealinthedaycareispartofthebudgetagreementfor2008.ThisActshallcomeintoforceon1January2011,butmunicipalitiescanalready1Januaryemphasizeparentalpaymentfromthecurrent25%toamaximumof30%ofthebudgetedgrossoperatingexpensesifthemunicipalityoffersalunchmealtoallchildreninmunicipaldaycare.Thebackgroundtothislawincludetheincreaseinoverweightandobesityamongchildrenandadolescents,asitwashighlightedintheintroduction.

Foodtales

Thefoodtalesweregiventheinterventionkindergartensbeforethesummer.Onlytwokindergartenshaverespondedthequestions.Theresultsofbothkindergartenswerethesame.Notofthepedagoguesfeltthatthechildrenwereinterestedinthestories,theycouldnotrelatetothestoryandthecharactersinthestoriesasbeingmorethanjustfiguresinastory.Theysawnoconnectiontothefruitandvegetablethattheycouldeat.Duetothefactthatthispartoftheprojectweredonewithoutobservationfromtheresearches,itisnotpossibletoconcludewhethermoreorlessengagementwouldhavemadeadifferentefficacy.Duetothefactthatonlyhalfthekindergartensrespondedtothequestions,

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itislikelytobelievethattheengagementandfeasibilityfromthepedagoguesnothavebeenveryconsistently.

PhysicalActivitybookMostofthegamesarenaturallybeingdonealreadyintheDanishkindergartens.DuetothefactthatmostoftheDanishkindergartenchildrenareoutside,beingphysicalactiveplayingbetween2‐5hoursaday,itisouropinionthattheefficacywouldbedifficulttomeasure(whetherornottherewasbeenatimedifferentinthephysicalactivitybeforeorafter).Instead,duetotheresultsfromtheobservationandfocusgroup,wehavechosentofocusonthegirls,sincetheyneededmoreencouragementfromthepedagoguestoplayphysicallyinsteadofstandingorsittingdownplaying.Thefeasibilityhasnotbeenoptimal.Accordinglytothepedagoguesthegirlsdidnotfindthegamesinterestingenough.Theyratherwantedtoplaythegamestheyalreadyplayedorusetheplayfacilitiesinthekindergarten.Likethefoodtales,thispartoftheprojectweredonewithoutobservationfromtheresearches,itisnotpossibletoconcludewhethermoreorlessengagementwouldhavemadeadifferentefficacy.Duetothefactthatonlyhalfthekindergartensrespondedtothequestions,itislikelytobelievethattheengagementandfeasibilityfromthepedagoguesnothavebeenveryconsistently.

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Litterateur•Andersen&Kjærulff,2003:"Whatcanchildrenrespond?‐Onchildrenasrespondentsinthequantitativesurveys.Copenhagen,InstituteofSocialResearch03:07•BUPLcapital:"PedagogicalPerspectivePlan"Source:http://www.bupl‐hovedstaden.dk/FAF/2003/2003.08.11%20p%C3%A6dgogiske%20persp%20ny%20version.pdfLastvisitdate:02/05/2009.•Broström,S.(2004):"Educationcurricula‐toworkwithdidacticsforkids."1.edition,1.oplag.SystimeAcademic.•StatisticsDenmark2006:"Almostall3‐5yearareininstitutes"NewsfromStatisticsSource:http://www.dst.dk/pukora/epub/Nyt/2006/NR005.pdfLastvisitdate:05.052009•Grønfeldt,V.etal(2007)"HowhealthyistheDanishkindergartens?Resultsfromthequestionnairesurveyamongdaycarefor3to6yearolds."1.Issue.FoodInstitute,DTUhttp://www.google.dk/search?hl=da&q=Hvor+sunde+er+de+danske+b%C3%B8rnehaver%3F+Resultater+fra+sp%C3%B8rgeskemaunders%C3%B8gelse+blandt+dagtilbud+til+3+%E2%80%93+6+%C3%A5rige&meta=Lastvisitdate.06.05.2009•Heary&Hennessy,2002:"TheUseofFocusGroupInterviewsinPediatricHealthCareResearch."JournalofPediatricPsychology,Vol.27,No.1,pp47‐57th•Holm,Letal(1999):"Mealsasfamily‐buildingandliberation".Kristensen,S.T.Foodanddrink.JournalAnthropologyNo39Metabolism,Copenhagen•Holm,L.(2003):"Food,peopleandmeals‐socialscienceperspectives."1.edition,2.printing.Munksgaard•Jensen,KO(2003):"Whatis'realfood'?"Holm,L..Food,peopleandmeals‐socialscienceperspectives.1.edition,2.printing.Munksgaard•Leon,F.(2006):"Children,Foodandpleasure".ChildreninEurope,p.18‐19.BUPL.•Lissau,I.etal(2006):"Foodandphysicalactivityinnurseries,schoolsandschool/schoolservices‐Developmentoffoodandmealsinschoolsandschool/schoolclubsfrom1999to2004",NationalInstituteofPublicHealth,Copenhagen•Rønholt,H.etal.2003:"VideoIneducationalresearch‐thebodyandexpressioninmovement."Publishermainland.