This thesis explores the effects of an innovation aimed at improving Greek primary school pupil's critical thinking on television food advertising and food choices in the context of the declining Mediterranean diet. In a review of the literature, some research demonstrated the effects of TV advertising on children while according to other studies, these effects remained doubtful. Findings were even hazier where food products were concerned. It is possible to sum up the problem as follows: whether sitting in front of the TV makes one eating snacks or eating snacks make one sit in front of the TV. Keeping in mind however, the social context in which Cretan children grow (highly touristic region, TV, working parents, more money) as well as the weaknesses of some of the above mentioned studies (small time span, laboratory settings), this thesis takes the position that advertising does playa part in this changing diet. Although there is no way to measure its exact effect on children, this position is strengthened by the fact that companies keep spending substantial amounts of money on advertising. Unfortunately the difficulty of establishing a causal connection between children's diet and television adverts affects in turn advertising regulations, which depend on the will of each particular country. It also affects the provision of consumer education in schools which is very limited. The study took place in Crete. which was selected mainly because of the researcher's origin and because of the undergoing change in the Cretan diet. During the last decades. the traditional Cretan/Mediterranean diet has shifted towards Western nutritional habits. This issue is largely ignored by the Greek educational system where teaching is fairly didactic and there are very few courses on health and none that relate to the media. Most of these are conducted on a pilot basis and are based on the commitment of individual teachers. The strengths of this research design were first that it took place in the pupil's natural environment and secondly that the education course was designed specifically for the Greek schoolchildren. The total number of children participating in this study was 190 (82 in the control and 108 in the experimental group). These children belonged to five primary schools of Iraklion city. which ranged from middle to working class and from deprived to affluent areas of the city. Data collection included a variety of tools such as questionnaires, interviews with each child, dietary records (completed by parents). classroom observations, children's work, and researcher diary. Data was collected at the start of fieldwork (baseline) after the end of the course (post intervention) and approximately 10 months after the end of fieldwork. The findings of this thesis demonstrate firstly the large differences among the four experimental teacher's teaching style. Although they had all been volunteers and expressed an interest in the programme, and had been informed and provided with the course material, only two were able to successfully implement the course. In the other two classes, the researcher felt obliged to intervene in order to substitute for teacher inadequacy, and to ensure that the pupils received an adequate course. The findings also showed that pupils and teachers were appreciative to progressive pedagogy and did not hesitate to criticize the didacticism of the Greek educational system. Although originally designed within a positivistic framework the researcher found herself increasingly drawn into the action frame of the implementation. This led in turn to participant observation, changes to the research design and new inSights for the researcher. The researcher'S personal change was another dimension of this study's findings as she learned to allow more space to her participants. Finally, the findings confirmed that children's dietary behaviour is not likely to change when addressed simply through a school based intervention. Pupil's critical thinking, though, was enhanced and it must be hoped that it will give the children the power to decide themselves the kinds of foods they wish to consume

The prevalence of childhood obesity is escalating rapidly and it considered to be a major public health problem. Diet is a recognised precursor of fatness, and current evidence supports the premise that in Westernised countries, the dietary intakes of children are likely to be important in obesity genesis. However, we have a relatively poor understanding of the environments in which a child’s eating is learnt and maintained. Much of the existing work in this area is based on small-scale or experimental studies, or has been derived from homogeneous populations within the USA. Despite these limitations, there is evidence that aspects of the child’s family environment are likely to be important in determining obesity risk in children. This thesis examines the impact of the family food environment on a child’s eating through two related studies. The first study, titled the Children and Family Eating (CAFÉ) study comprised three phases. Phase one involved qualitative interviews with 17 parents of 5-6 year-old children to explore parental perceptions regarding those factors in a child’s environment believed to influence the development of their child’s eating habits. These interviews were used to inform the development of quantitative measures of the family food environment. The second phase involved the development of a Food Frequency Questionnaire (FFQ) to assess dietary intake in 5-6 year-olds. The FFQ was informed by analysis of 1995 Australian National Nutrition Survey data. In the final phase the relationships between dietary intakes of 5-6 year-old children, and potential predictors of dietary intake were examined in a cross-sectional study of 560 families. Predictors included measures of: parental perceptions of the adequacy of their child’s diet; food availability and accessibility; child-feeding; the opportunities for parental modelling of food intake; a child’s television exposure; maternal Body Mass Index; and maternal education. Analysis of the CAFÉ data provides unique information regarding the relationships between a child’s family food environment and their food consumption. Models developed for a range of dietary outcomes considered to be predictive of increased risk for obesity, including total energy and fat intakes, vegetable variety, vegetable consumption, and high-energy (non-dairy) fluid consumption, explained between 11 and 20 percent of the variance in dietary intake. Two aspects of the family food environment, parental perception of a child’s dietary adequacy, and the total minutes of television viewed per day, were frequently found to be predictive of dietary outcomes likely to promote fatness in these children. The second study, titled the Parent Education and Support (PEAS) Feeding Intervention Study, was a prospective pre/post non-randomised intervention trial that assessed the impact of a feeding intervention to 240 first-time mothers of one-year-old children. This intervention focused on one aspect of the family food environment, child-feeding, which has been proposed as influential in the development of obesogenic eating behaviours. In this study, Maternal and Child Health Nurses (MCHNs), using a ‘Division of Responsibility’ model of feeding, taught parents to provide nutritious food at regular intervals and to let children decide if to eat and how much to eat. Thus parents were encourages to food their child without exerting pressure, or employing coercion or rewards (controlling behaviours). The aim was to influence parental attitudes and beliefs regarding child-feeding. Through the use of these feeding techniques, this intervention also aimed to increase the variety of fruits and vegetables a child consumed by teaching parents to persist with offering these foods, over the year of the intervention, in non-emotive environments. Fruits and vegetables were chosen in this intervention because they are likely to be protective in the development of obesity. Analysis of the PEAS data suggests that this low-level feeding intervention, delivered through existing Maternal and Child Health services, was modestly effective in changing parental attitudes and beliefs regarding the feeding of young children. Further, the validity of fruits offered to intervention group children increased. This thesis expands the existing knowledge base by providing a comprehensive analysis of the relative impact of aspects of the family environment on dietary intakes of 5-6 year-olds. Further, the analysis of a feeding intervention in first-time parents provides important insights regarding the potential to influence child-feeding and the impact this may have on the promotion of eating behaviours protective against obesity.