IN several Asian countries, such as Japan and Korea, nutritionists are being hired in primary schools to inculcate healthy eating habits in the young. Can this be emulated here?
“I hate to draw comparisons, but one can’t help but point out the system in Japan, where every school has a nutritionist. For us here, I am not advocating that for now, but for a start, perhaps a nutritionist can be assigned to be in charge of several schools, ” said Nutrition Society of Malaysia (NSM) president Dr Tee E. Siong.
“Investing in the nutritional wellbeing of children today is the only way to ensure a healthier generation of adults tomorrow,” said Dr Tee, a former head of the cardiovascular, diabetes and nutrition research centre of the Institute for Medical Research.
The need to place nutritionists in schools is already in the soon-to-be released National Plan of Action for Nutrition of Malaysia III (2016-2025).
“However, there has to be serious efforts in realising the strategies in the Plan. In 2014, NSM conducted a nationwide study called “My Breakfast”, of over 8,000 primary and secondary school children. It found that the number of overweight and obese children in rural and urban areas was high, at close to 30 per cent in primary and secondary children.
“There is also a significant prevalence of stunting (seven per cent). This is alarming. We cannot ignore the issue of stunting in our schoolchildren because stunting can lead to obesity if a stunted child piles on the pounds. The condition also affects mental development and a stunted child will face difficulties learning,” he cautioned.
The study aimed to determine the habits and types of food most commonly consumed by schoolchildren. It showed a higher prevalence of those who were overweight and obesity among schoolchildren with low physical activity (27.1 per cent) compared with children with medium (25.7 per cent) and high 23.3 per cent physical activity levels.
NSM is proposing to teach nutrition in schools.
“NSM has developed a package of nutrition modules, called the ‘Healthy Kids Programme’ (HKP), and we tested them over three years. It starts from Year 3, and follows the same children to Year 4 and 5, teaching slightly more in-depth topics each year. The modules are taught over several months, most often during the Pendidikan Jasmani dan Kesihatan lesson. In 2014, we started the first stage of the programme, involving schoolchildren in Year 3, in 70 schools across Sabah and Sarawak,” said Dr Tee.
“We monitored the children and found they had improved in their knowledge about nutrition and tended to practise healthier eating habits. We are concluding the third part (Year 5) of its implementation in these schools.”
NSM is proposing that these modules be implemented in all primary schools across the country.
“We believe that these lessons will be useful in improving knowledge and inculcating good eating habits in children. Hopefully, they will make healthier choices, which will push canteen operators to make changes in their food,” said Dr Tee.
However, Dr Tee said concentrating on encouraging canteen operators alone to prepare healthier foods would not be effective.
“They will still sell unhealthy foods, such as nuggets and sausages, because the kids like them, and the operators are profit-motivated.
“It is workable as it does not require a revamp of the school curriculum. The modules also do not interfere with regular subjects. Our HKP programme has fun elements and interactive sessions.”
Dr Tee said instead of infectious diseases of the 1960s and 70s, today, more children were at risk of developing non-communicable diseases. The most important risk factors are being overweight and obesity. Through weight and height monitoring programmes in schools, nutritionists can help in the monitoring and referral of under- and over-nourished children.
“Having nutritionists in schools will be good because they will facilitate food- and nutrition-related activities. Working with the school authorities and parent-teacher associations, nutritionists can ensure the implementation of school canteen guidelines and provide ideas to canteen operators on how to prepare healthier meals.
“An obese child is more likely to grow up to be an obese adolescent, and an overweight or obese adult. The origins of many non-communicable diseases, such as cholesterol build-up in the blood vessels and high blood glucose, start from the primary school age.
“I have been advocating for this to happen. I truly believe that promoting healthy eating and active living must start from young, and schools are one of the most suitable venues to inculcate good eating habits in children. I believe the Education and Health Ministries can work on a comprehensive long-term plan to improve the nutrition of schoolchildren in the country.”
Dr Tee said these programmes could be spearheaded with the help of professional bodies, such as NSM, as well as roping in the private sector.
Malaysian Dietitians’ Association (MDA) president Professor Dr Winnie Chee welcomed the idea and described it as a long-awaited initiative.
“I am glad to see this happening, especially with the rise in obesity among schoolchildren.
“The school canteen guidelines developed by the government should be strictly enforced in all schools. It promotes the sale of healthy food and minimises unhealthy choices offered by food vendors,” Dr Chee said.
Learning and practising good nutrition should also be fun and stimulate young minds, she added.
“Schools can consider conducting cooking classes for children, where they can learn to prepare simple healthy meals or snacks while having fun. They can also be inspired by the TV programme Masterchef for kids. I think it is also important for children to learn traditional recipes and make healthier versions of them.
“Additionally, they can be encouraged to cultivate small gardens at home, where vegetables can be planted. Schools can set up home gardens and culinary clubs.
“All these activities promote home cooking and increase vegetable and fruit intake, which are important messages about healthy eating for the young.”