Thesis (M. Tech. (Food Service Management, Dept. of Hospitality and Tourism))--Vaal Univrsity of Technology. / Inadequate food intake and unhygienic practices are usually associated with poor nutrition practices. Malnutrition stems from poor quality and quantity of foods, but is also contributed to by factors of inadequate maternal and child health care, lack of education and information and insufficient health services. The first phase of this study was to assess the nutritional status and nutritional knowledge of primary school children within a peri-urban community, through the implementation of a situational analysis. Validated 24-hour (hr) recall, food frequency (FFQ), nutrition knowledge and health questionnaires were used to conduct the situational analysis of this community. Parents (n=52) representative of 400 (13.0 percent) children voluntarily agreed to participate and 45 children completed the baseline survey. Results indicated a community faced with poverty as unemployment (60.9 percent) was high, education levels amongst the parents ranging between primary (33.3 percent) and secondary school (54.9 percent). The dietary patterns of the children revealed a carbohydrate-based diet with very few (n=2) consuming a variety of fruit and vegetables. Some nutrition knowledge amongst the children was evident, with a mean 60.2 percent in correct answers for the true/false questions. The children within the community were at risk of becoming stunted, with small numbers having deficiencies in iron. Therefore, it was decided to implement a nutrition education programme (NEP) in the second phase of the study to address malnutrition amongst primary school children. The objectives of the second phase were 1) to implement a NEP amongst the primary school children to assess the impact on nutrition knowledge and dietary practice, and 2) to determine the retention of knowledge after nine months and whether any correlation occurred between knowledge and dietary practices. The school environment was chosen to ensure attendance and create a suitable learning environment to which the children were already accustomed. Two groups, namely experimental (n=82) and control (n=91), were assigned for this study. The control group received no form of nutrition education during the intervention period. The experimental group received nine 45 minute lessons over a period of nine weeks. The nutrition education tools (NETs) were made up of a text and activity book, supplemented by a card and board game. Pre- and post-nutrition intervention knowledge and 24-hr recall questionnaires were completed to assess differences in nutrition knowledge and dietary practices between the two groups. The intervention made a significant impact on the nutrition knowledge of the experimental group, with a 13 percent improvement between pre and post results. Topics which required more emphasis included the importance of variety in the diet, the functions and sources of certain nutrients, and the classification of certain food groups and the daily serving requirements. In the long-term evaluation, nutrition knowledge was retained and related to topics of the inclusion of milk and fat on a daily basis, the serving size of starch, dairy products and fruit and vegetables, and the classification of low-fat snack items. Retention of knowledge was poor for the source of vitamin C. A few changes were made in the dietary choices of the children after the intervention, with the inclusion of more carbohydrates and one fruit. During the long-term evaluation, the children included more protein sources, but carbohydrates remained dominant within the Top 20 list. The energy distribution in the long term changed towards more energy being supplied from protein (15.6 percent) and fat (34.4 percent), compared with post results of 13.7 and 25.8 percent respectively. The multivariate analysis revealed a significant correlation between the protein intake of the Top 20 list and the question relating to the number of eggs (p=0.00) to be consumed daily, as well as the link between vitamin C (p=0.00) and fruit and vegetable intake. A limitation is that a small number of children (n=27) could not complete the post test, with another 34 children not present to complete the long-term evaluation. The children had very little control of the dietary patterns as their mothers were primarily responsible for food procurement, preparation and feeding. A recommendation is to commence the intervention in the beginning of the year and to consider a co-ordinated approach with parents to encourage dietary changes. / Vaal University of Technology and SANPAD

In 2001, the percentage of fourth grade students who were overweight (26%) in Wells County, Indiana was twice the national average (13%). A Robert Wood Johnson Local Initiative Funding Partners grant was submitted and received to provide this community with resources to help combat unhealthy lifestyles. The purpose of this study was to examine differences in body mass index, food choices and nutrition knowledge and attitudes of fourth grade students in Wells County to determine if the prevalence of overweight had been reduced, and provide insight into children's food choices and nutrition knowledge. Of the 1,347 fourth grade students who completed the SPAN questionnaire over the four years, 23 percent were overweight. Over the four years, the prevalence of overweight did not increase to higher levels, providing modest support for the impact of Operation Wellness on students' weight. The students in this rural community ate fewer meals, snacked more frequently, did not eat enough fruits or vegetables, and ate too many high-fat/high-sugar foods compared to recommended standards. Students from the Southern Wells School District were significantly more aware of the relationship between diet, weight, and health than students in the other two school districts. / Department of Family and Consumer Sciences

Submitted in the fulfillment of the requirements of a Masters of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2017. / Aim: The main aim of this study was to profile the primary school children`s household socio-economic status and evaluate their nutritional status for a healthy and active live in Chesterville, outside Durban in KwaZulu-Natal. The sample comprised of 250 children (147 girls and 103 boys), aged between 4 to 8 years and 9 to 13 years who volunteered to participate in the study and school was randomly selected. Methodology: A quantitative research method was applied using various nutrition security assessment tools complemented by the socio-economic household profile to determine household`s ability to acquire food. Anthropometric status using WHO growth indicators assessed stunting, wasting and underweight status of the children. This was followed by the 24-hr recall and food frequency questionnaire to probe children`s diet diversity. Descriptive statistics was used to analyse data. Result: The anthropometric indices showed that 10.3% of the children were severely stunted (<-3SD height-for-age), 33.5% were stunted (<-2SD), 2.9% were severely wasted (<-3SD BMI-for age), 5.3% were wasted (<-2SD) with 68.5% at possible risk of overweight (>+1SD), 24.3% of the children were overweight is (>+2SD) and 5.6% were obese (>+3SD) according to the WHO z-scores. The results indicate the prevalence of obesity which could be a result of the high consumption of carbohydrate dense food in the group surveyed. The parents/ caregivers and the children need nutrition education on healthy eating habits to improve their lifestyle. The socio-demographic profile of the households indicated that 61% of the parents/ caregivers were unemployed and 39% were employed. Seventy three percent of the households were headed by women, 50% of the parents/ caregivers owned their homes, 63.6% had a tap inside the house and 94% had access to a flush toilet/sewerage system inside the house, 38% had passed grade 8 – the highest level of education, 14.4% of the parents/caregivers earned less than R2000 per month, and 10.4% earned less than R2500 per month. The low-income level, lack of post matric qualification in some of the parents /caregivers and the high unemployment rate of 61% could be a contributory factor to malnutrition in this community. Most of the parents/caregivers resided in the township and 94% lived in brick houses, while 35.6% lived in a shack that was built outside the house as an extension of the house. Most of the parents/caregivers (88%) purchased their food from a supermarket. Thirty-five-point two percent of the parents/ caregivers indicated not having enough money to spend on food, 32.8% indicated that often there is not enough money to spend on food, and 15% indicted that there is always not enough money to spend on food. Seventy-five-point two percent of the parents/ caregivers purchased their food once a month while 12.4% purchased their food once a week. Township South Africans tend to purchase food instead of growing their own food because of the lack of vegetating space. The lack of buying power and food shortages eventually leads to malnutrition. The lack of higher education in this community decreases the chances of permanent employment as a result the low-income bracket and the inability to purchase food in some occasions. The food group diversity score showed that 64% of the respondents consumed food from nine food groups. The carbohydrate group had the highest score (6.08±1.322) followed by the vegetable group (4.76±1.383) and the meat group (4.51±1.269). The mean carbohydrate intake was higher than the Dietary Reference Intake (DRI) for girls and boys (>100% of the DRIs). The intake of fruit was lower than the >400g goal as recommended by the World Health Organisation (WHO). The consumption of fibre was low with both girls and boys consuming <100% of the fibre requirements. Iron was consumed by 54.6% of the girls in the required amount of 100% of the DRIs. The energy intake for both girls and boys was 7025.8±16278 and 7205.4± 1860.834 respectively. The girls’ consumption of protein was 11.9% and boys’ consumption was 11.4% and this is within the recommended 10-15% of the WHO. Conclusion: The results indicate both overnutrition and undernutrition in children that were part of the survey. The top 20 food intake indicated inadequate eating patterns and that diets consisted of energy dense foods, such as carbohydrates and fats which could be responsible for obesity in the children. The high unemployment and low-income rate and inadequate money to spend on food can contribute to the prevalence of stunting and wasting in the children. Nutrition education and nutrition interventions such as focus on healthier foods, healthier methods of preparing food, a balance diet and physical activity are necessary to improve quality of life and improve health. / M

Thesis (MTech (Public Management))--Cape Peninsula University of Technology, 2009 / The study centres on the school feeding programme in the Bonteheuwel area, which is a predominantly Coloured residential area in close proximity to Cape Town International Airport. The school feeding programme is a national initiative that is driven by the Western Cape Education Department on a provincial level. The research investigated whether the school feeding scheme is being implemented effectively and efficiently. This implies that it was necessary to determine:  The current status of school feeding in Bonteheuwel;  Whether it adequately meets the needs of needy learners; and  If the current scheme is found to be inadequate, what can be done to improve the situation? As the study uses both descriptive and empirical approaches, a questionnaire was constructed to obtain views of selected members of Bonteheuwel’s community. Responses to the questions/statements in the questionnaire were analysed by a Cape Peninsula University of Technology registered statistician and the statistical analysis provided positive answers to the above determinations, which revealed that the school feeding programme was not effective and that more should be done to improve its delivery. The final chapter proposes a number of recommendations to improve implementation of the school feeding programmme.

The aim of this study was to explore and describe the body fatness and associated selected health risk factors among 10 to 12 year old adolescents attending schools in Port Elizabeth. Therefore the objectives of the study were to determine the following for the participants: • Level of fatness: weight, height, waist circumference, maximum hip circumference and skinfolds; • Fat intake; • Level of physical activity involvement (IPAQ). To achieve the aim and objectives of this study, the literature pertaining to Childhood Obesity and the possible effects thereof, were reviewed. Both an ex post facto quasi experimental and randomized one-group posttest only designs were used to describe the level of fatness and to identify the incidence of overweight and obesity among adolescents aged 10 to 12 years attending schools in Port Elizabeth. The test battery included anthropometric measurements that were identified from the literature as the factors most important to categorise body fatness such as weight, height, circumferences and skinfolds to determine the level of fatness of the participants. A 21-item Fat Measure for Dietary Intake and International Physical Activity Questionnaire were administered to determine the levels of fat intake and physical activity. Three hundred (300) adolescents were assessed of which 143 were male and 157 were female. In terms of socioeconomic status, 71.3 percent were from the ‘less poor’ quintile schools and 28.7 percent were from the ‘more poor’ quintile schools. The results obtained from the evaluation of the samples were compared in terms of their descriptive statistics and the differences were tested for statistical and practical significance. The results from the study showed that 26.7 percent of the participants were overweight and 14.7 percent were obese according to their skinfold measurements. In terms of body mass index, 79.7 percent of the participants were overweight and 14.3 percent were obese. These results are far higher than majority of the studies included. Physical activity indicated a reduction in body fatness and the most physically active participants were obese. Lastly, body fat percentage and body mass index are very closely related.

Submitted in fulfillment of the requirements of the Master of Applied Science in Food and Nutrition, Durban University of Technology, Durban, South Africa, 2016. / Introduction: South Africa, like many other developing countries, is challenged by malnutrition among children. Globally, the nutritional status of children is a cause for great concern. The nutritional shift towards diets laden with sugar, fat and salt contribute towards the burden of non-communicable diseases (NCDs). Snacking plays a pivotal role in the diets of children; however, the consumption of unhealthy snacks or ‘junk’ food poses a serious risk to a child’s nutritional well-being. Moringa oleifera was selected for snack food development in this study, as this plant is a significant source of nutrients. Aim: The aim of this study was to determine the snacking preferences of children (grades 4-7 in four schools in Verulam, KwaZulu-Natal (KZN), South Africa, in order to develop a sensory acceptable snack enhanced with Moringa oleifera. Methodology: Two hundred primary school children between grades 4-7 were selected through stratified random sampling of schools in Verulam, KZN, South Africa through informed consent to participate in this study. In addition, ten parents/caregivers formed part of the preliminary study to determine the snacking habits of children in the selected grades. This information was reported in the form of themes. A Snack Food Frequency Questionnaire (SFFQ) was administered to children for the sole purpose of determining snacking preferences. This was supplemented by an observational study to assist with identifying the most frequent tuck shop purchases. Thereafter, once the top three snack items were identified, the main study continued with the development of a healthy snack, through three cooking trials before an appropriate product was developed. The final product was made using three different amounts of dried Moringa leaves (1g Moringa, 2g Moringa and 3g Moringa per 22g portion) in a maize chip. The developed product was then subjected to nutrient testing in order to determine the vitamin A, zinc, iron and calcium content of the three different variants. The carbohydrate, fat, energy and sodium values were calculated by using the Association of Official Analytical Chemists (AOAC) International standardised methods. Microbiological and shelf life testing were also conducted to ensure the chips were safe for human consumption. Consumer acceptance sensory evaluation was conducted among the children (n=100) to determine the most preferred amount of Moringa leaf in the snack food item (either 1g of Moringa or 2g Moringa). To determine which of the two variants (sample 1 containing 1g of Moringa and sample 2 containing 2g Moringa) was preferred, two variants of the product were sampled by the participants; samples were coded in order to prevent bias. Results: Overall, the results from the focus group study revealed that children consumed snacks frequently and were given money regularly to purchase snack items from the school tuck shop. Price was a trend noted in factors that affect snack selection. The parents/caregivers responded positively towards purchasing a snack that was nutrient-rich. However, it was noted that the price should be reasonable. Results of the SFFQ indicated that the most popular snack items were chips, cold drinks and sweets; therefore these items were reviewed to determine the most viable option for further development. It was decided by the researcher and the supervisor that chips would be the snack item enhanced with three different amounts of Moringa. The consumer acceptance sensory evaluation comprised two chip samples (123 and ABC). The results of the consumer acceptance sensory evaluation showed that sample ABC (2g Moringa/22g serving) was preferred to sample 123 (1g Moringa/22g serving) for most of the sensory attributes (taste and texture). The Moringa chips (both samples) contain almost half the amount of sodium (52.8mg) when compared to a popular corn chip brand (100mg). Moringa chips contained almost less than 1 gram of fat compared to 8 grams of fat found in the corn chips children usually consume. One portion (22g) of the Moringa chips contributes a significant amount of non-haem iron (57.89%, 48.25% and 35.61% for sample 1, 2 and 3 respectively) for females aged between 9-13 years old. Conclusion: Moringa chips (2g/22g serving) received a positive response from children in the sample population. The use of indigenous plants such as Moringa, could be beneficial in food based strategies aimed at addressing malnutrition. Recommendations: This study concluded that food based strategies such as the development of the Moringa chips, should be considered as a means to create a healthy option for children in low socio-economic schools. / M

Introduction: This dissertation investigates the critical components of school-based food and nutrition education (SBFNE) programs aimed at enhancing their impact on students’ dietary behaviors. Over the past century, significant shifts in the food landscape have altered dietary habits, with a rise in ultra-processed food (UPF) consumption and a decline in fruit and vegetable intake, particularly among children. This trend underscores the importance of SBFNE programs, which, akin to STEAM subjects, are vital for public health. Schools, where children spend much of their time, are ideal settings for implementing comprehensive, research-based SBFNE programs to reconnect students with healthy food sources and promote better eating habits. Research Questions: This three-paper dissertation addresses several key research questions: 1. What educational and programmatic components contribute to effective SBFNE programs? 2. How can these components be synthesized into a comprehensive theoretical framework and practical program evaluation tool? 3. What insights and recommendations can be gathered from a formative evaluation of these tools? Chapter 2 (Article 1): Objective: Identify educational and programmatic components from the research literature that make SBFNE effective in fostering positive dietary behavior among K-12 students. Methodology: An umbrella review of peer-reviewed literature reviews and government reviews on the effectiveness of SBFNE. All included reviews were assessed for methodological quality. Data Analysis: For each included review, a list was made of the components that contribute to the effectiveness of SBFNE to change dietary behavior. These components were compared across reviews. A final list of components contributing to effectiveness of SBFBE was created with their prevalence in the included reviews indicating whether the impact on effectiveness of SBFNE was positive, mixed or not assessed. Key Findings: This umbrella review identified 20 critical components essential for effective SBFNE programs from 44 reviews, encompassing 1,115 unique primary studies conducted between 1900 and 2022. These components, such as cultural inclusivity and connections to school meals, were integrated into a structured theoretical framework based on the Socioecological Model (SEM) with the components mapped to the first four of six SEM levels: individual, interpersonal, community, and organizational. Conclusions: This study is the first to identify and map research-based critical components into an SEM framework, that influence behaviors and outcomes and can be used to further SBFNE research. Chapter 3 (Article 2): Objective: Develop and pilot test a SBFNE program evaluation tool derived from 20 critical components that were integrated into an SEM framework. Methodology: The tool, developed in Google Sheets, employed a 0-3 scoring system to evaluate the integration of each component with an accompanying detailed rating guide. The pilot test involved component ranking exercises, concept mapping, and curriculum lesson reviews with SBFNE program developers (n=3). Data Analysis: Insights from the pilot test led to significant refinements in the tool and data collection protocol. Key Findings: Participants found the ranking exercise uncomfortable due to component interdependencies. They found the concept mapping exercise engaging and intuitive. The program developers found the curriculum review to be tedious and insufficient with only one lesson reviewed, but they thought this type of program review provided valuable guidance for revising and improving SBFNE programs. The interviews were long, usually more than two hours, and transcription was time-consuming. Conclusions: The pilot provided data to refine the program evaluation tool and to refine the data collection protocol for a formative evaluation of the program evaluation tool. Chapter 4 (Article 3): Objective: Conduct a formative, mixed-methods evaluation to refine the integrated SEM and program evaluation tool for SBFNE programs. Methodology: Recruited SBFNE program developers (n=9) who participated in an exercise to categorize 20 critical components for effectiveness of SBFNE, created a concept map on how the 20 components interact, underwent a program review in which programs were scored 0–3 for the 20 components, received recommendations for program improvement for components that scored less than a three, decided on which recommendations they would enact, and provided feedback on the experience. Data Analysis: Descriptive statistics and thematic analysis identified patterns and insights from qualitative responses, leading to revisions in the evaluation tool and a new practice-based tool. Key Findings: For the categorization exercise there was a range of agreement between program developers and the literature on the critical nature of the SBFNE components, with each of the nine participants rating between four and 17 out of the 20 components as essential. The concept maps the program developers created represented the interconnectedness of the components and led to the development of a practice-based logic model. The program review process showed that programs can be scored on how they are using the components, recommendations can be made for components that did not score a three, and program developers can implement the recommendations. The feedback process indicated that program developers found the activities they did for this research useful for refining and improving their programs, to make them more effective at dietary behavior change. Conclusions: The program evaluation tool and new practice-based model showed promise to be used in future research on SBFNE. Conclusions: This dissertation establishes a robust foundation for SBFNE, integrating critical educational and programmatic components with innovative evaluation tools. The integrated SEM and practical program evaluation tools can improve the quality of SBFNE programs, which can help to foster positive dietary behavior change among K-12 students, addressing the rise in UPF consumption and decline in fruit and vegetable intake. This research lays the groundwork for future initiatives aimed at nurturing healthier, informed, and empowered generations.

Thesis (MPhil) Stellenbosch University, 2014 / ENGLISH ABSTRACT: In an increasingly complex world where food security remains a challenge in many areas and especially Africa; it is essential to educate children about food – from production to consumption; and to ensure they eat enough as this is a crucial factor for concentration and learning abilities. How can we teach children about food in a sustainable way? This study focuses on schools in Tigray, Northern Ethiopia, which have a school feeding programme, school garden and nutrition curriculum. The question studied is: To what extent do two primary schools in central- and east Tigray (North Ethiopia) integrate the feeding scheme, school garden and nutrition curriculum? The methodology chosen is a case study and the empirical data was collected through interviews, surveys and observations. Principals of 14 schools were interviewed about the school gardens, curricula and school gardens. Two schools were then selected for a further in-depth research. The school gardens, mostly initiated by the staff, serve the purpose of creating income for the school and teaching students the skills of gardening. The curriculum is standard for Tigray and focuses on different food types and creating a balanced diet. The school food in most schools is provided by the World Food Programme (WFP), but some exceptions exist. This research shows that integration between the three objectives will be beneficial. Obstacles include getting the staff ‘on board’ as a priority and controlling the unification of the three, for example schools feel that they have less ownership over the feeding scheme because it is organised by an external NGO. This study suggests stakeholders view school gardens, nutrition education and school feeding schemes under one umbrella for the ultimate benefit of creating a sustainable model to teach about food. The case study provides an insight to the specific challenges in Tigray, Ethiopia but important conclusions can also be generalised. / AFRIKAANSE OPSOMMING: In ’n toenemend komplekse wêreld waar voedsel sekuriteit in baie gebiede, veral in Afrika ’n uitdaging bly, is dit baie belangrik om kinders oor voedsel op te voed - vanaf produksie tot by die verbruik daarvan, en ook om seker te maak dat hulle genoeg eet, wat baie belangrik is vir konsentrasie en die vermoë om te leer. Hoe kan ons kinders op ’n volhoubare manier leer oor voeding? Hierdie studie fokus op twee skole in Tigray, in Ethiopië wat skoolvoedingskemas, skooltuine en voedingkurrikula het. Die vraag wat gevra is, is: Tot watter mate integreer hierdie twee skole in Tigray die voedingskemas, die skooltuine en die voedingkurrikula? Die gekose metodologie is ’n gevallestudie. Empiriese data is ook deur middel van onderhoude, oorsigte en observasies versamel. Onderhoude oor skooltuine, voedingskemas en die kurrikula is gevoer met die skoolhoofde van 14 skole. Twee skole is toe gekies vir in-diepte navorsing. Die skooltuine bring geld in vir die skool en word ook gebruik om vir die leerling tuinmaakvaardighede aan te leer. Die kurrikulum is standaard vir die hele Tigray en word deur die Wêreld Voedsel Program verskaf. Daar is egter ’n paar uitsonderings. In hierdie navorsing is daar bewys dat die integrasie van die skooltuin, die voedingskema en die kurrikula, goeie gevolge kan hê. Dit is egter belangrik dat die skool personeel moet saamwerk en dat die vereniging van die drie beheer moet word. Skole voel bv. Tans dat hulle nie eienaarskap oor die voedingskema het nie, want dit word deur eksterne NROs beheer. Hierdie navorser stel voor dat die skooltuine, skoolvoedingskema en die voedingkurrikulum onder een sambreel beskou moet word met die doel om ’n volhoudbare model vir die onderrig van voeding te skep. Die gevallestudie verskaf insig in die spesifieke uitdagings in Tigray, Ethiopië, maar belangrike slotsomme kan ook veralgemeen word.

Aim: To determine whether the tuck shop purchasing habits of Grade 4 learners were contributing towards the development of childhood overweight and obesity. Objectives: To assess the nutritional quality of the food and beverages available for learners to purchase; items regularly purchased from the tuck shop as well as factors influencing the learner’s decision to purchase these items; the anthropometric and socio-demographic characteristics of grade 4 learners as well as their nutrition knowledge related to the tuck shop items purchased. Method: A survey administered to 11 tuck shop managers, a questionnaire administered to 311 Grade 4 learners and two single-sex focus groups of 5 learners each were conducted. Results: Fifty six percent of the sample were female (n=173) and 44% were male (n=138). Twenty seven percent of the study sample was overweight (n = 83) and 27% were obese (n = 85). Eighty six percent of learners (n = 266) claimed to buy from their school tuck shop. Twenty two percent of learners purchased from their tuck shop at least three times per week (n =58). Learners who purchased from the tuck shop had a significantly higher BMI than those who did not (p = 0.020). Learners who purchased from the tuck shop spent on average R8,38 per day with a minimum of R1 and a maximum of R40 (standard deviation R5.39). The most popular reasons for visiting the tuck shop included “this is my favourite thing to eat or drink” (66.5%, n = 177) and “I only have enough money to buy this item” (47.0%, n = 125). Savoury pies were the most popular "lunch" item for all learners for both food breaks (45%, n = 5 schools and 27.3%, n = 3 schools) selling the most number of units (43) per day at eight of the eleven schools (72.7%). Iced popsicles were sold at almost every school, ranked as the cheapest beverage and also sold the most number of units (40.7). Healthy beverages sold included canned fruit juice and water, while healthy snacks consisted of dried fruit, fruit salad, bananas, yoghurt and health muffins. The average healthy snack contained almost half the kilojoules of its unhealthy counterpart (465kJ vs 806kJ). Nutritional analyses of the healthy lunch options revealed total fat contents that exceeded the DRI and South African recommended limit. Perceived barriers to stocking healthy items included cost and refrigeration restrictions. The average score for the food groups was only 33% indicating that learners were not familiar with the Food Based Dietary Guidelines (FBDG). Further analyses showed that the total knowledge scores of those learners that reported to buy from the tuck shop frequently, was significantly lower when compared to the total knowledge scores of those learners who bought from the tuck shop less frequently (13.0 ± 3.9 and 11.6 ± 3.1, respectively; p < 0.05). Logistic regression analysis confirmed that the total knowledge of a learner could be used to predict whether he or she is more likely to make purchases from the tuck shop (significance = 0.017). Focus group results revealed that learners are aware of “healthy” and “unhealthy” tuck shop items. Most learners stated that they would continue to purchase items from their tuck shop if all “unhealthy” items were removed. Conclusion: Primary school tuck shops of well resourced schools in Pietermaritzburg are contributing to childhood overweight and obesity through a combination of factors. These include the poor nutritional quality of the items stocked at the tuck shop as well as the poor tuck shop purchasing practices. Much consultation is required amongst dieticians, school principals and privatised tuck shop managers to overcome barriers to stocking healthy items. School management and government have an important role to play in imposing restrictions on the sale of unhealthy items; along with improving the quality of the nutrition education curriculum to ensure that learners are able to translate their knowledge into healthier purchasing practices. / Thesis (Ph.D.)-University of KwaZulu-Natal, Pietermaritzburg, 2011.

Thesis (MNutr (Human Nutrition))--Stellenbosch University, 2008. / There is convincing evidence linking school feeding to improved educational outcomes. The Primary School Nutrition Programme (PSNP) was first implemented in 1994 and aimed to improve educational outcomes by alleviating short-term hunger and improving school attendance and punctuality. Responsibility for the programme was transferred from the Department of Health (DoH) to the Department of Education (DoE) in 2004 and the name was changed to the National School Nutrition Programme (NSNP) at this time. Previous evaluations of the PSNP / NSNP had reported problems associated with foodservice management and general management aspects of the programme. The study was a cross-sectional, observational investigation of foodservice management and general management practices in primary schools running the National School Nutrition Programme (NSNP) in Pietermaritzburg, KwaZulu-Natal. Twenty-three schools were visited to investigate practices at each school relating to compliance with DoE menus and prescribed service time of the meal, the food delivery system and utilities available. The food handling and hygiene training and practices and general management practices linked to the NSNP were investigated. Most of the schools (78%) were using the DoE menus but only half (52%) served the meal at or before 10h00, which is an ongoing problem. Receiving and storage procedures were adequate at most schools. Food quality does not appear to be a problem in the Pietermaritzburg schools. The lack of expiry dates on food packages remains a problem area and should be addressed. Most of the schools had a designated kitchen area but these facilities could be upgraded. Most schools cooked on gas and 35% of schools had no running water in the kitchen. Kitchens should, at least, have hot and cold running water and adequate working space. Most schools reported that they run out of gas during the month. The monthly DoE allocation for gas should be reviewed to ensure schools have enough gas for the whole month. The holding time for cooked food should be kept to a minimum to minimise the risk of food poisoning. Some schools had insufficient plates (26%) and cutlery (35%). Standardised portion sizes were served at 70% of schools and food handlers reported that learners usually finish all the food. Food handlers at 70% of the schools had received training in food safety and hygiene but 26% of these had only received training once. Training was found to be significantly associated with hand washing (p=0.002), clean uniforms (p=0.036) iv and sanitising practices (p=0.035). Training should be provided in short, ongoing sessions. General management aspects of the NSNP remain a problem. Policies and procedures should be drawn up and implemented to provide a minimum standard of operations at schools. Monitoring should be conducted on a regular basis. The NSNP is running reasonably well in Pietermaritzburg. Adhering to prescribed meal times and upgrading kitchen facilities could result in improvements. Food handler training could also be conducted more frequently. General management aspects need to be improved.