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know more about schoolchildren’s nutritional needs
understand the nutritional requirements for school lunch / snacks guidelines
learn to make use of the ‘NutriAgent’ Handbook
understand how to use the monitor / assessment forms to keep check on the nutritional standard of school lunch / snacks
Before leaving for Before leaving for the day, you’ll…the day, you’ll…
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‘‘You’-orientedYou’-oriented
Cross-sector synergistic Cross-sector synergistic cooperationcooperation
Continual supportContinual support
Appreciation and rewardAppreciation and reward
Assessment and reviewAssessment and review
Leaving a lasting Leaving a lasting reputationreputation
Stormy and perilousStormy and perilous
Completely exposed to Completely exposed to drawbacks from all sidesdrawbacks from all sides
Countless difficulties and Countless difficulties and barricadesbarricades
Strength-exhausting and Strength-exhausting and brain-rackingbrain-racking
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Health and NutritionNutritional Guidelines on School Lunch for Primary Students and compliance monitorNutritional Guidelines on Snacks for Primary Students and compliance monitorOrganising projects promoting healthy eating at schoolSupport, record and rewardQ&A sharing
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• The 3 major factors below count 60% on the death toll* in Hong Kong:– Cancer (33%)– Heart diseases (16.3%)– Cerebrovascular diseases (10.5%)
• Unhealthy dietary habitsincrease the risk of chronic illnessescause overweight and obesity
*Data of 2005 *
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* Data Source: DH Student Health Service
• The percentage of primary schoolchildren with obesity*
Boys Girls Total
0.0%
5.0%
10.0%
15.0%
20.0%
25.0%
97/98 98/99 99/00 00/01 01/02 02/03 03/04 04/05 05/06
男生女生總計
• rose from 16.4% in 1997/98
• to 19.4% in 2005/06
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Energy Input
Energy Output
Obesity refers to the excessive storage of fat in the body, which may cause health impairment
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ChildrenChildren
– Growth Charts
e.g. : Weight-for-Height Chart
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Healthy eating habits built up in childhood are more likely to be carried on into adulthoodSchoolchildren generally fail to follow healthy eating principlesStudies abroad pointed out that school-based intervention programmes are found with proven effectiveness in promoting healthy dietary habits among schoolchildren
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95.6% 95.9% 95.0% 97.7%
2.3%5.0%4.1%4.4%
Healthier
More unhealthy
Yoghurt Wheat bread with raisin
Chicken leg in Chinese ‘Lo Shui’ sauce
Pure orange juice
Ice cream Hot dog Deep-fried chicken leg
Soft drink
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Healthier
More unhealthy
Yoghurt Wheat bread with raisin
Chicken leg in Chinese ‘Lo Shui’ sauce
Pure orange juice
Ice cream Hot dog Deep-fried chicken leg
Soft drink
51.9% 50.9%34.8% 35.1%
48.1% 49.1%65.2% 64.9%
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Recipes with ‘less healthy ingredients’
63.2%
Recipes without ‘less
healthy ingredients’
36.8%
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‘Snacks to choose more’
‘Snacks to choose in moderation’
‘Snacks to choose less’
Items soldat tuck shops
Items soldin vending machines
Items broughtto school from home
55.7% 61.3%35.6%
29.7% 28.8%
51.3%
14.6% 10.0% 13.1%
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dietary habits and health are closely related
the existence of substantial gap between students’ knowledge and practice of healthy eating
teachers and parents have to be role models
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To work together with us and give our next To work together with us and give our next generation a healthy eating environment!generation a healthy eating environment!
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School ‘NutriAgent’ Project
Nutritional Training Workshop
Techniques of surveillance & negotiation
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In this session, you’ll: Understand how to undertake surveillance of
the school eating environment
Know more about schoolchildren’s nutritional needs
Understand the qualitative and quantitative requirements in the Nutritional Guidelines on School Lunch / Snacks for Primary School Students
Learn to answer some FAQs about diet
Know how to use surveillance forms to keep the nutritional standard of school lunch / snacks in check
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How to undertake surveillance of the
school eating environment?
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What is Surveillance?
Data Collection
Data Collation
Data Analysis
Dissemination
Actions for Improvement
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What we need for surveillance at school:
Basic knowledge of nutrition
Simple tools for lunch / snack surveillance
Items to be negotiated with lunch suppliers or tuck shop operators
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School Lunch Surveillance
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Nutritional Guidelines on School Lunch for Primary
School Students
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With the guidelines, we hope to…
Achieve energy balance
Increase intake of fruit & vegetables
Reduce total intake of fat, sugar and salt
in students’ diet
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About the guidelines:
(1) Guidelines on Quantity
(2) Guidelines on Quality
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(1) Guidelines on Quantity
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How much should a schoolchild eat?
??
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Food Pyramid for Children
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A healthy lunch should…
provide schoolchildren with of the nutrients
they need every dayone third
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Tips on healthy lunch box
Grains & cereals, vegetables and meat should be in the ratio of : :
by volume3 2 1
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Recommended Quantity of Lunch for Junior and Senior Primary School Students
Food Group P.1 – P.3 Students P.4 – P.6 Students
Grains & Cereals At least 4 servings At least 5 servings
Vegetables At least 1 serving At least 1 serving
Meat, Poultry, Fish, Eggs, Legumes
1-2 servings 1½ - 2½ servings
Fruit At least ½ serving At least ½ serving
Fats and Oil Max. 2 servings Max. 2 servings
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What is ‘serving’? unit of recommended serving
size helps maintain a balanced diet used for describing the
recommended quantity of food needed daily from the 5 food groups
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One serving =Grains & cereals
Vegetables
Meat, Legumes,
Eggs ~1/5 bowl
~1/4 bowl of noodles
~1/3 bowl
~1/2 slice of bread
~ 1 as big as an egg
1 bowl of raw
1/2 bowl of cooked
4 slides of cooked
1/2 bowl of cooked
1/3 bowl
1
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One serving =Fruit Fats and Oils
1 medium-sized (as big as a fist)
1/2
1 handful (about 10 grapes)
1 glass (150ml)
1/2 box of unsweetened dried fruit
1 tsp of plant oil
1 tbsp of salad dressing
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(2) Guidelines On Quality
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How to choose ‘quality’ healthy lunch
for children?
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Quality Food 3 lows, 1 high:
Low-fat, low-sugar, low-salt and high-fibre
Types of food in lunch:
Encouraged food items Limited food items Strongly discouraged
food items
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Natural and fresh
‘3 lows, 1 high’ food
Encouraged Food Items
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Encouraged Food Items
Whole-wheat or high-fibre grains & cereals
Low-fat dairy products or other calcium-rich food
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Limited Food Items
Processed / preserved food or food with added oil, salt or sugar
High-salt or high-fat sauce and gravy
≤ 2 days/week
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Limited Food Items
Grains and cereals with added fat or oile.g. fried rice, fried noodles, fried rice noodles, baked rice with excess sauce
*Remark: It is recommended that sauce or gravy with high salt or fat content should be served sparingly and separately.
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Limited Food Items
Fatty cut of meat and poultry with skine.g. chicken wings, spare ribs, chicken legs, ox belly, fatty minced meat cake
Whole-fat dairy productse.g. full-cream milk, regular cheese, full-cream yoghurt
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Limited Food Items Processed or preserved meat,
eggs and vegetablese.g. sausages, ham, BBQ pork, preserved mustard green
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Strongly Discouraged Food Items Food very high in fat, salt or
sugar
Food with added animal fat, plant saturated fat and trans fat
SayNO!
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Strongly Discouraged Food Items
Deep-fried food
Deep-fried fish filletFrench
fries
Deep-fried chicken
leg
Deep-fried Tofu
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Strongly Discouraged Food Items
Food with added animal fat, plant-based saturated fat and hydrogenated fate.g. lard, chicken oil, butter, coconut oil, palm oil, margarine
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Strongly Discouraged Food Items Desserts or beverages containing
more than 10 grams or 2 tsp of added sugar in each serving
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Strongly Discouraged Food Items Very salty food
e.g. preserved meat sausages, salted fish, salted eggs, etc.
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FAQs on Children’s Diet
About lunch
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FAQs on Children’s Diet
Is potato vegetable?
No, it belongs to the Grains & Cereals group.
Other plant foods in the grains and cereals group include corn, taro, sweet potato and carrot, yet they are also counted as vegetables.
Pumpkin is in the ‘Vegetables’ group only.
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FAQs on Children’s Diet
How many calories should be provided in children’s lunch ?
About 650kcal
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FAQs on Children’s DietIs the quantity in lunch for junior primary
students same as that for senior ones ?
No. As the daily nutritional needs of these 2 groups are not the same, their demand for grains & cereals and meat
are also different. Please refer to ‘Nutritional Guidelines on Lunch for
Primary Students’ for more information.
As for the recommended amount of vegetables and fruit, it is generally the
same for all students.
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FAQs on Children’s Diet
Is margarine healthier than butter that we can feel free to use more for cooking?
No. It’s because margarine contains trans fat which will also adversely affect our blood cholesterol level and increase
the risk of cardiovascular diseases or stroke. Moreover, margarine has the same calorie content as butter, which may also lead to obesity if consumed
excessively.
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Tools for Lunch Surveillance in
Primary Schools
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Nutritional Quality Evaluation Form of School Lunch
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For whom to use? When to use?
Assign two teachers or parents
Once a month
Choose a week with 5 consecutive school days to be the assessment week
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What you need:
(2) Nutritional Quality Evaluation Form of
School Lunch
(3) Lunches of the week
(1) Grouping list of food items for lunch
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2 3
1
5
4
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How to observe changes in food quality?
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E.g. Low-fat Curry Chicken with Vegetable Red Rice
Low-fat Curry Chicken with Vegetable Red Rice
23/9 362
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Action Time!
Activity 1
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Dissemination of Surveillance Results
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School Executives, Headmasters / Teachers
Lunch Suppliers
Parents
Students
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Negotiation with school lunch suppliers School and PTA may take the surveillance
results as an item for negotiation Should the surveillance results show the
followings:• fruit supply %
• vegetable supply %
• Encouraged Food Items %
• Limited or Strongly Discouraged Food Items %
communication with suppliers have to be promptly initiated for improvement.
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Things to remind…• Always be positive• Gather and select comments or
suggestions in advance• Realize that meat is not the main part
of lunch, but grains and vegetables are
• Tasty = full-flavored / salty• Nutritional value should always be
the top priority when choosing a lunch supplier
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Take Home Messages(on lunch)
Grains and cereals, vegetables and meat = 3 : 2 : 1
‘3 Lows, 1 High’ should be the rule for food
Cook with less oil
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3 2 1 Healthy Lunch Suitable for Everyone
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Let’s Take a Break!!!
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School Snack Surveillance
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Nutritional Guidelines on Snacks for Primary School Students
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What is Snack?‘Snack’ means an amount of food
smaller than a meal eaten informally between meals.
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Is snack a must? Snack is not main meal Just children eat adequately in a
balanced way and don’t feel hungry between main meals
Snack is not a must!
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Snack is appropriate if children: feel hungry between main meals; eat snacks at the right time; and eat in small amount which does
not affect the appetite for the main meals
Parents may consider giving them some healthy snacks!
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But in many cases…Children might feel hungry between meals
because of:
Small stomach, small capacity High energy output Imbalanced diet in the day
So we can have some snacks if that doesn’t
affect our appetite for the
main meals!
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The right time for snacks…
There should be at least
between snacks and main mealsto avoid spoiling children’s appetite for
the next meal.
1.5 – 2 hours
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Appropriate serving size for snacks…
e.g. : 1 slice of wheat bread +
1 glass of low-fat milk 1 apple + 1 glass of
water 2-3 plain biscuits + 1
glass of pure fruit juice
It is usually smaller than that for a main meal, and it does not mean
to replace the main one.
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How to choose healthy snacks? Snacks to Choose More Snacks to Choose in
Moderation Snacks to Choose Less
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Snacks to Choose More
Criteria for selection:
Containing at least one type of nutrients (e.g. dietary fibre, protein, calcium), and
‘3 Lows, 1 High’ Principle
Low in fat
Low in sugar
Low in salt
High in fibre
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Bread and grains and cereals that are low in fat, salt & sugar
Snacks to Choose More
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Fresh vegetables and fruit, and unsweetened dried fruit
Snacks to Choose More
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Snacks to Choose More
Low-fat dairy products
Low-fat yoghurt
Low-fat milk
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Snacks to Choose in Moderation
containing at least one type of nutrients (e.g. calcium and dietary fibre)
but also containing fat and added sugar or salt
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Snacks to Choose in Moderation Bread and cereals
with added fat, sugar or salt
Processed and preserved vegetables
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Snacks to Choose in Moderation
Fruit with added sugar
Whole-fat dairy products
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Snacks to Choose in Moderation
Fatty, processed or preserved meat and its alternatives
Beverages with added sugar but also contain nutritional value
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Snacks to Choose LessFood or beverages low in
nutritional value but high in fat, sugar and salt
Frequent consumption of these snacks may increase the risk of:
• Obesity• Heart diseases• Diabetes• High blood pressure
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Snacks to Choose Less
Snacks high in fat, sugar and salt
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Beverages
Choose More Water
Pure fruit juice
Low-fat milk
Choose in Moderation
Sweetened fruit juice
Sweetened soya milk, whole-fat milk, chocolate milk
Choose Less Soft drink, sweetened cartoned drink, cordials, black tea, coffee
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Food Label Reading
Source of Information: Food and Environmental Hygiene Department
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What can food labels do?
Help consumers: better understand the nutritional value
of food compare similar food products make healthier food choices or select
suitable food for disease management
Food labels can encourage food manufacturers to:
improve nutritional content of products
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Content of food labels
Food labels
Nutrition labelling
Nutrition claims Function claimsHealth claims
Claims
Nutrient content claim
Nutrient comparative
claim
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Types of nutrition labels
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Types of nutrition labels
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How to read nutrition labels?Step 1: Find out the serving size
Udon
How many grams are there in 1 serving of Udon?
4 servings
200 grams
How many servings are there in 1 pack of Udon?
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How to use nutrition labels?
Step 2: Check out the calorie content
How many calories are there in 1 pack of Udon?
320kcal
1280kcal
How many calories are there in 1 serving of Udon?
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How to use nutrition labels?
Step 3: Look for the nutritional valueWhat is the unit of
nutritional content?Per Serving
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How to compare the nutritional value of food?
‘Per Serving’ The amount of
nutrient you consume
‘Per 100g’ For compare
the nutritional values of different food items using 100g as a unit
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Which one is better?
Milk A Milk B
Calories
CalciumProtein
Dietary fibre
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FAQs on children’s diet
About
snacks
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FAQs on children’s dietThere are many beverages on the market coming with health claims.
Can these claims be trusted?
Not all beverages with health claims are healthy. Parents may refer to the ingredient list on the package to see where ‘sugar’ is put.
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FAQs on children’s diet
Is it right for children to skip breakfast to avoid over-eating if they eat snacks during recesses?
No.
Breakfast is one of the main meals. It should not be skipped and should be
eaten at regular time. It should mainly consist of grains and cereals (e.g. bread, congee or oatmeal). Skipping breakfast may lead to over-eating at recesses or
lunch.
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FAQs on children’s diet
Children love choosing fried and deep-fried snacks. How can we help
them to get rid of these food?
We can first reduce children’s weekly frequency of intake. Then gradually, we can use some fresh food such as vegetables or fruit to replace them.
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FAQs on children’s diet
Would low-fat dairy products like milk, yoghurt or cheese be less nutritive
than full-fat ones?
No. All dairy food is rich in calcium, which is good for teeth and bone
growth. In fact, the nutritional content of low-fat dairy products are similar to those of the full-fat ones, especially in
terms of protein and calcium. In addition, low-fat dairy products are
lower in calories and fat, thus benefit our body more.
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FAQs on children’s diet
Can sports drinks be provided for children instead of water?
Sports drinks or electrolyte-charging drinks are specially
designed for athletes. Children should not take sports drinks for
water to replenish water loss during study or exercise.
Rather, plain water is the best refill.
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Tools for Snack Surveillance
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School Snacks Monitoring Checklist
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For whom to use? When to use? assign two teachers or
parents
use monthly
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What you need:
(3) A list of snacks and beverages supplied at school tuck shop and/or vending machines
(2) School Snacks Monitoring Checklist
(1) Snack categorising list
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1 2
3 4
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How to observe changes in snack quality
Snacks to Choose Less
Snacks to Choose in Moderation
Snacks to Choose More
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French fries Choose Less
Boiled corn
Choose in moderation / Choose more
Bean curd dessert
Chocolate milk Choose in moderation
Raisin puff Choose in Moderation
Orange-flavoured drink
Choose less
Cookies Choose less
Let’s group them up
Choose more
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Action Time!
Activity 2
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Dissemination of Surveillance Results
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School Executives, Headmasters / Teachers
Tuck shop operators
Parents
Students
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Negotiation with tuck shop operator
School and PTA may take the surveillance results as an item for negotiation
Should the surveillance results show the followings:
• ‘Snacks to Choose More’ %
• ‘Snacks to Choose in Moderation’ & ‘Snacks
to Choose Less’ % communication with operators have to be
promptly initiated for improvement.
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Things to remind…
• Always be positive• Both ‘Snacks to Choose More’ &
‘Snacks to Choose in Moderation’ can be sold at school tuck shop
• Small, individual servings of snacks can be offered
• Avoid using food as reward• Encourage students not to bring
‘Snacks to Choose Less’ back to school so as to build up a healthy eating environment
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Ways to encourage
children to eat more healthy food
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Way 1:Make salad with colourful fruit and
vegetables, eggs and little low-fat salad dressing to attract children. This could be a dessert after meal or tea refreshment.
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Way 2:Parents may go shopping with children
and buy their favourite fruit. Children are encouraged to take part in the preparation, so as to increase their
interest in eating fruit and vegetables.
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Way 3: Food substitution
Luncheon meat and ham sandwich
Wholewheat bread with fresh tomato & boiled egg
Full-fat dairy products
Low-fat dairy products
French fries Baked mashed potato / Baked potato wedges
Potato chips Cornflakes or fruit chips
Deep-fried chicken leg and wing
Baked chicken leg or breast (skinned)
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Way 4:
Try mixing food that children have never tried or dislike with those they like. Start with a small amount and gradually increase the portion.
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Take Home Messages(on snacks)
1. Snacks could not replace main meals
2. Better to have a time lag of 1.5-2 hours between snacks and main meal
3. Choose ‘3 Lows, 1 High’ Snacks
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‘1 High, 3 Lows’ Snacks
Healthy and Tasty
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• To provide teaching resources and templates for reference
• To assist teachers and parents in running healthy eating activities
• To simplify the procedure of organising activities for saving teachers’ and parents’ time
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1. How to formulate ‘School Healthy Eating Policy’?2. Undertaking surveillance of school eating
environment (lunch and snacks)3. Methods of planning and procedures of running
activities4. Proposals on projects / programmes promoting
healthy eating5. Support, record and reward
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We have developed We have developed 26 26 proposals of promotional proposals of promotional activity in activity in TWOTWO categories: categories:
1. Policy, surveillance, environment and behaviour
2. Knowledge, attitude and awareness
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(1) Formulating healthy eating policy(2) Healthy eating surveillance in action – lunch(3) Healthy eating surveillance in action – snacks(4) DIY surveys of healthy eating environment and students’ dietary habits(5) Work together to promote lunch guideline policy(6) Tuck shop of health and nutrition(7) Red-yellow-green snacks zoning system(8) Give tuck shop a new face(9) Teacher-Student Fruit Day(10) ‘Choose the Smart and Healthy Lunch’ Campaign(11) Lunchtime broadcast on nutritional analysis of meal(12) A Lunchtime for Parents and Students
Policy, surveillance, environment and behaviourPolicy, surveillance, environment and behaviour
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Knowledge, Attitude and AwarenessKnowledge, Attitude and Awareness(13) Visit to kitchens of school lunch suppliers(14) Parent-child Snacks Campaign(15) Healthy Eating Ambassadors(16) Healthy Eating Carnival(17) Healthy Eating Garden(18) Healthy Eating Quiz(19) Publishing in-school healthy eating quarterly by students(20) Healthy eating API making competition(21) Healthy Eating poster design competition(22) Healthy Eating story competition(23) Model making competition of Healthy food teaching aid(24) Healthy lunch / snacks comic strip competition(25) Healthy Snacks Catwalk Show(26) Healthy gourmet’s dish paper plate drawing competition
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** No less than two activities are to be conducted for the academic year 2006-2007
• Specially recommended activitiesSpecially recommended activities (2) Healthy eating surveillance in action -- Lunch (3) Healthy eating surveillance in action -- Snacks
• Optional activitiesOptional activities Activities suggested in the Handbook and other school-
based activities designed for healthy eating promotion
School ‘NutriAgent’ Project School ‘NutriAgent’ Project RequirementsRequirements
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Professional adviceProfessional advice– Through our enquiry hotline, our Through our enquiry hotline, our
professional team provide professional team provide consultancy on:consultancy on:
• the process of organising eventsthe process of organising events• problem solvingproblem solving• resources availableresources available• recommendation of community recommendation of community
resourcesresources• the progress follow-up of the the progress follow-up of the
programme organisation for the programme organisation for the yearyear
Resources availableResources available
– Health education Health education resourcesresources
– Community Community resourcesresources
Volunteers’ supportVolunteers’ support
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AppreciationRecord and Reward
AppreciationRecord and Reward
Appreciation and commendation to the Appreciation and commendation to the ‘NutriAgents’ who are cordially devoted to ‘NutriAgents’ who are cordially devoted to
proactive running of events promoting proactive running of events promoting healthy eating in schoolhealthy eating in school
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• ProposalsProposals
• Evaluation ReportsEvaluation Reports
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Evaluation ReportsEvaluation Reports
• Photographs, promotion posters, Photographs, promotion posters, questionnaires and results of evaluation studyquestionnaires and results of evaluation study
• By post, fax or e-mail to DHBy post, fax or e-mail to DH
• For events lasting longer than 8 weeks, an For events lasting longer than 8 weeks, an interim report is to be submitted, followed by interim report is to be submitted, followed by the final report upon the completion of event.the final report upon the completion of event.
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• Judging criteriaJudging criteria– Nature of eventNature of event
(Policy / Environment, continual surveillance, knowledge / (Policy / Environment, continual surveillance, knowledge / concern)concern)
– Scale of eventScale of event
(Number of participating parents / students / members of (Number of participating parents / students / members of the community)the community)
– DurationDuration
– Participation of volunteersParticipation of volunteers
– Evaluation of effectivenessEvaluation of effectiveness
• Record of the event’s scoring Record of the event’s scoring
– NutriSchool RecordNutriSchool Record
– NutriAgent RecordNutriAgent Record
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• InfinityInfinity
• Childhood obesityChildhood obesity
• Chronic illnessesChronic illnesses
• EnjoyEnjoy
of satisfactionof satisfaction
no moreno more
morbidity declinesmorbidity declines
lifelife