Evaluation of a School Canteen according to the Dubai Health Authorities Guidelines - Research Paper Example

Table of Contents College of Sustainability Sciences and Humanities Spring 3 Literature review 4 Introduction 4 Prevention in Schools 4 Decision-making 4 DHA recommendations for school canteens 5 Healthier food choices 6 Aims & Objectives: 6 Aim: 6 Research question 6 Null hypothesis 7 Methodology: 7 Developing the checklist: 7 Evaluation of canteen: 7 Results: 9 Findings: 11 Weaknesses 12 Recommendations for improvement of School Canteen 12 Project Timeline 13 Annex: 13 Annex 1: Timetable 13 Bibliography 15 Abstract: This is paper contains a project that aims to evaluate a school canteen according to the Dubai Health Authorities guidelines. It contains statistics relating to the prevalence of health problems that relate to diets in the UAE, as well as studies and guidelines and recommendations in other countries. The aim of this paper is to assess and recommend healthier option for one of the private schools in Dubai. The school canteen got and 80% score from the checklist, which indicated that in corresponds with the DHA guidelines in many aspects of it school canteen Literature review Introduction Overweight and obesity are a state of excessive fat accumulation in the body that may impair health. According to 2015 WHO, “In 2014, more than 1.9 billion adults, 18 years and older, were overweight. Of these over 600 million were obese.” However it is also stated by the WHO, that obesity is preventable. One of the most influential parts of prevention is behavioral change at a young age. Obesity prevalence within UAE is rather high as stated by the International journal of obesity, “58.9% normal weight, 14.7% overweight and 18.9% obesity”. This could be based on many factors but in this study the focus will be on how the school cafeteria can contribute to make the children have healthier choice and therefore decrease the obesity level in the school children. Prevention in Schools Schools forms essential platform for overweight deterrence. Since schools and in specific school canteens reach many children and most of their time is spent in schools. Schools canteens are considered to be a relevant and important setting for the prevention of overweight and obesity. The environmental factors are important in creating the individuals behavior, and this is not a new concept. In the 1930s, Lewin highlighted that both the person and the environment need to be taken into consideration when studying human behavior (Journal of Environmental and Public Health, Volume 2012). Decision-making Decision-making and choice behavior usually results from one of two distinct cognitive processes: reflective or impulsive processes. (D. Kahneman, 2003). The reflective system part of decision-making is when the people think carefully and they act upon targets and plans. On the other hand, the impulsive system part of decision-making, the people act more automatically and naturally and are usually led by instincts. It is under the impulsive system circumstances that the environmental cues can strongly affect people’s decisions and behavior. (D. Kahneman, 2003). The decision making that implies when people have well-developed eating habits, and they are not involved in their eating choices. The environment is likely to be a strong leading factor to determine their eating behavior (Journal of Environmental and Public Health, Volume 2012). In this study it is important that the impulsive decision-making is taken in consideration because the environmental factor is the canteen. Most of students time remains spent in schools from the age of 4 years to 17 years old. This is important to put in mind because it is the age where their decision-making skills are developed as well as their habits, specifically eating habits. If they are well developed it can prevent obesity or unhealthy weight that are led by unhealthy food choices. Although there are some students that have packed lunches from home, the education on healthy eating habit would have to be targeted to the parents if the students are still at a young age. However if they are older they have freedom of choices and by making the school canteen a healthier environment the student would most probably be influenced to make healthier choices. Furthermore, education to these students is vital so that they understand why healthier choices would benefit them in the future and at the current time. DHA recommendations for school canteens According to the DHA, Al Jassmi explained that the guidelines put by the ministry focusses in enhancing and establishing healthier eating habits among school students. It also aims to make the students capable to make the right decision of healthy food choices. As Al Jassmi clearly pointed out that, “Schools are an environment where children spend many hours in the day and therefore it is crucial to promote and support their knowledge with regards to healthy nutrition in schools.” According to the 2012, Journal of Environmental and Public Health, there are many reasons why targeting students suggests a great possibility to increase healthy eating habits because the eating habits that are developed in the early life stages may continue into adulthood and that would mean once an unhealthy habit has been founded in their behavior it is difficult to change later on. Healthier food choices According to TNO, 2008, when cafeteria offerings would be mainly healthy and the food would be made more appealing to students, it is expected that it would increase healthy choices. To support that, a study by TNO has demonstrated that this can be effective ways to encouraging healthy eating behavior in students. This is by changing the choices in the vending machines into low-calorie snacks, and juices, this resulted in better food choices made by students. Also according to Mark Vallianatos, 2015, as part of the checklist made for the schools in the United States, “Unhealthy beverages and foods may not be sold by any group conducting a fundraiser on school grounds or given to students as a reward”. This is an important aspect because if students see unhealthy foods as an award they would start to have the wrong perspective about healthy eating. This would show them that healthy food is not something to look for whereas the unhealthy resembles reward relating to a needed outcome. Aims & Objectives: Aim: The research aims at evaluation of school canteen by filling in a checklist made specifically for school canteens. Using the guidelines and recommendations of Dubai Health Authorities. Then spread awareness amongst the school canteen workers and people in charge, and give nutritional assessment and advice on the guidelines that could be followed to make the canteen a healthier and more appealing place to eat for school students. Research question Is there a relationship between eating habits and food offered at a school canteen to students between the ages 5– 17 years in schools in Dubai? Null hypothesis There is no relationship between food choices and food offered at the school canteens. Methodology: Developing the checklist: The checklist was made using the DHA guidelines and recommendations for a healthy school cafeteria. This method was used so that I can see if the school cafeteria is following most or all the requirements set by Dubai Health Authorities. The objective of the DHA guidelines was to encourage the development of healthy eating habits among school children. Simultaneously, it provides a wide range of options for healthy food and drinks in schools. Furthermore, it aimed to enhance the intake of nutritious and well balanced diet among students (Food Control Dept , 2011) The checklist was split into the different food groups and that was useful to see and evaluate where the school had strengths or weaknesses. There were 5 main groups in the checklist mainly according to my plate, the categories used were: Dairy products, Group of meat, fish, poultry and pulses, Group of carbohydrates, Group of fruits and vegetables and Prohibited Food Items in School Canteens. In the dairy products section the focus was whether the items were low fat or not, if they short life or long life. In the Meat and Poultry group it was focused whether or not the items were lean and if there are any meat substitutes for vegetarians. For the Carbohydrates group the checklist emphasized on the availability of whole wheat bread, and the amount of sugar added in the cereals or juices. Then the fruits and vegetables part was mainly emphasizing of availability of different fruits and at a reasonable price. The final part was about prohibited foods in the canteen like soft drinks, candies, chewing gum and energy drinks. Evaluation of canteen: The evaluation of the canteen would be by putting scores from 1 to 3. 3 being the best and 1 is the worst. This way the school canteen evaluation would show where it stand from the DHA guidelines. Then recommendation could be given according to the scores gained from the checklist. Pictures also were taken so the presentation of the healthy food choices could be visually assessed. Developing the aforementioned criteria of evaluating the canteen would be imperative in establishing whether the school has complied with approved DHA standards on food safety and provisions. The main aim of modern school canteens entails preventing unhealthy risks associated with eating including obesity and poor eating behaviors. Since the DHA guidelines outlines the healthy guidelines involved in establishing a school, developing an evaluation checklist for the school canteen was easier. Firstly, I grouped the canteen foods based on my plate guidelines offered by DHA. As outlined, the groupings included Biscuits and sweets, dairy products, groups of meat, fish, carbohydrates and their products, groups of vegetables and fruits, and the general foods prohibited within canteens. Classification of the food collection within the school canteen into six (6) influential food groups remained imperative in developing my checklist and subsequent evaluation of the schools’ performance. After grouping of the foods as aforementioned, it was imperative to develop study questions that would assist in effective scoring and evaluation of canteen performance based on DHA guidelines. Consequently, I developed various questions in relation to the DHA most recognized guidelines for establishing a school canteen. The questions would be essential in establishing whether the school canteen follows the DHA established guidelines. The school canteen would earn points within the 1-3 scale based on its strict adherence to the DHA guidelines of establishing such food shops. Consequently, the developed checklist would then find use in practical evaluation of the canteen. During the process, physical evaluation and assessment of the canteen helped in answering the previously developed questions. Once physical examination remains accomplished, scoring would follow within the given scale by choosing the most applicable answer that would correspond to the specified score. For instance, an examination of the school revealed that it does not serve biscuits to students. Since DHA do not recommend serving of biscuits within canteens, the school scored a scale of 3 on the discipline. Subsequent evaluation using the adopted criteria assisted in completing the exercise successfully. The subsequent results after evaluation process would evidently indicate whether the school canteen adheres to specified guidelines or not. Moreover, adoption of the scoring system would indicate performance of the canteen in maintaining DHA standards relating to healthy food provision. Effective interpretation of thee established results would be imperative in improving health status and nutritional requirements of the specified school canteen. Results obtained within the checklist evaluation form are as outlined below, Results: 3 2 1 Biscuits and sweets Does the school canteen serve biscuits to students No Yes, sometimes Yes, everyday If the biscuit is a chocolate biscuit, is the biscuit the predominant part Yes Partially No Dairy products The dairy products used are pasteurized & long life prepared from fresh milk. Yes, they are pasteurized and short life They are pasteurized & long life They are long life Does the canteen serve milk with natural flavors like strawberry or chocolate Natural flavors used Natural and artificial flavors No, no flavored milk Does the shelf life for dairy products exceed 2 thirds of their total shelf life? No, none of the items Yes, some of the items Yes, all of the items Does the school canteen serve low fat dairy products? Yes, all of the items Yes, but also there is full fat milk No, only full fat milk Group of meat, fish, poultry and pulses Are the meat and poultry served skinless and free of fat? Yes, all meat and poultry are skinless Yes, some of the meat and poultry are skinless No, most of the meat and poultry are not skinless or fat free Does the canteen provide vegetarian choices like using beans as a substitute for meat product? Yes, all the time there is a substitute Yes, sometimes there is a substitute No Group of carbohydrates and their products Does the canteen serve whole wheat bread Yes all the breads served are whole-wheat Some of the bread are whole wheat and some are not No Does the percentage of added sugar exceed 6g/100g? (cereals or juices) Yes, all the time Yes, sometimes depending on what food is served No Group of fruits and vegetables 
 Does the canteen offer 3 types of fresh seasonal fruits daily? Yes, everyday Sometimes, its not consistent supply of fruits for students No (less than 3) Are the fruit salads that are sold at reasonable prices? The price for the amount is appropriate. The price for the amount is not appropriate No Does the canteen serve green salads at all times? Yes Sometimes No Prohibited Food Items in School Canteens Are the synthetic colorants and additives, such as Monosodium glutamate, in the food prepared? Yes, in all the foods It depend on which food No Are soup concentrates used in soups? No Sometimes depending on what soup is prepared Yes, all the time Does the school canteen supply energy drinks or sodas? No Sometimes Yes all the time Does the school canteen serve chewing gum and candies? No Sometimes Yes all the time Findings: The canteen checklist evaluation showed that the school cafeteria met some of the DHA guidelines but lacked on some other points. The total score out of 51 for this specific school canteen was 41. A score of 41/51 reflects a performance percentage of approximately 80%, an indication that the school canteen adheres to a high percentage of DHA guidelines performance. The remaining 20% represents failure of the school canteen in adhering to DHA guidelines. The percentage indicates need for the school to improve its strategies in providing certain types of food based on the recommended standards by DHA. For instance, the canteen fails in selling white breads exclusively. However, DHA guidelines recommends that canteens should maintain sale of white breads to help in maintaining the health status of students. In addition, the school canteen sells skinless meat contrary to DHA guidelines of avoiding such foods. Consequently, the established findings and interpretations remains imperative in helping the school to improve their adherence to DHA guidelines. Highlighting the school canteen’s poor performance based on the evaluation checklist would help it in improving nutritional requirements and health status of the institution. Weaknesses The foremost weakness of the school canteen as established during the evaluation process entailed absence of hot foods. DHA recommended inclusion of hot food within the canteen to assist in balancing the dietary needs. Nutritional balance requires inclusion of hot foods for healthier reasons and body requirements. The canteen should establish strategies for providing hot foods including coffee drinks to health meet some of the DHA guidelines. Besides, the school also fails in selling white bread as the dominant type recommended by DHA. As aforementioned, DHA guidelines indicates that school canteens should deal exclusively in wheat breads sale. Moreover, the school canteen also has a major weakness of inconsistency relating to provision of certain recommended types of meat foods. For instance, DHA guidelines indicates that canteens should only sell skinless free meat but the school sometimes does the opposite as indicated in the evaluation checklist. Recommendations for improvement of School Canteen In ensuring adherence to DHA guidelines on effective nutrition provision, the specified school should establish a holistic approach. The approach would be imperative in providing the school community with essential information relating to heathy eating habits, nutrition, and food safety requirements. The holistic approach would also be domineering in establishing attitudes, believes, and values relating to consumption of food. Besides, the institution should work in association with food safety authorities in engaging school teachers, workers, and administrators in enhancing canteen nutrition. The engagement should encompass training and incorporate a similar program to parents and students. In addition, the school should actively involve nutrition and health professionals in helping them enhance heathier food consumption behaviors within the student community. Development of unitary dietary guidelines would also be essential in promoting the practice of recommended food consumption amongst students and the community around the school. Moreover, establishment of effective awareness campaigns within the school community would also promote healthy eating habits amongst students. Most importantly, the school administration should establish a leadership framework that values healthy living amongst students. Establishing an honest leadership framework within the institution would enable the school workers to adhere to the recommended DHA guidelines. Project Timeline The timeline of the research is provided as annex 1 Annex: Annex 1: Timetable Activities Timeline in weeks (3 months) W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12 Topic selection Literature review Research problem, objective, and Hypothesis Develop the research instruments Define research design Define research target areas & sample population Develop the questionnaire Get the approval Data collection Data entry Data analyses Write the research Presentation Bibliography Zaken, Taken Voor (TNO), “Automatisch gezonder? Resultaten van het school snack- en frisdrankautomatenproject,” 2008. International Journal of Obesity (2013) 37, 68–74; doi:10.1038/ijo.2012.131; published online 14 August 2012 K. Lewin, Field Theory in Social Science: Selected Theoretical Papers, Harper & Row, New York, NY, USA, 1951. 
 N. Diliberti, P. L. Bordi, M. T. Conklin, L. S. Roe, and B. J. Rolls, “Increased portion size leads to increased energy intake in a restaurant meal,” Obesity Research, vol. 12, no. 3, pp. 562– 568, 2004.  D. Kahneman, “A perspective on judgment and choice: map- ping bounded rationality,” American Psychologist, vol. 58, no. 9, pp. 697–720, 2003. 
 K. E. Stanovich and R. F. West, “Individual differences in rea- soning: implications for the rationality debate?” Behavioral and Brain Sciences, vol. 23, no. 5, pp. 645–726, 2000. 
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