Parents' and teachers' perceptions of the effects of diet on children's mental performance

Abstract

The present work aims to qualitatively and quantitatively examine the current consumers’ perceptions and beliefs of the relationship between what children eat and their mental development, state and performance. The research was divided into three studies, carried out in four European countries and funded within the framework of the NUTRIMENTHE project which aims to further our understanding and knowledge of the effect of nutrition on the mental development and performance in children. Understanding the relationship between nutrition and mental performance in children is important in terms of their attainment and productivity both in school and later life. Since consumers are seen as nutritional gatekeepers with responsibility for their children’s diets, their views and beliefs are of crucial importance. In this study, parents and teachers of primary school children perceive that diet is a less important determinant of mental than physical development. Furthermore diet is seen as a less important influence on mental performance than factors such as sleep and the quality of teaching. In our studies in four European countries this is true for a higher proportion of parents than teachers. Parents rely largely on their own experience when choosing food for their children and rate the healthiness of food as the most important influence on those choices. Also some country differences emerged from our results, particularly for parents, but these must be interpreted with caution given the large sample size whereby small differences become statistically significant. These findings have public health policy implications. Promoting the importance of diet for mental performance is important to address those consumers who are less health conscious. But there is a need for a broad deep evidence base before messages and interventions can be developed to reduce the level of scientific uncertainty in this domain. Furthermore, before making decisions about developing interactions and strategy as for messages to be effective there is a need to know how parents and teachers relate food consumption to the mental performance. This Doctoral Thesis represents a number of significant findings from one of the first multicentre studies of parents’ and teachers’ perceptions of how nutrition may have an influence on childrens’ mental performance. With this work we have addressed a number of gaps in the research to date of consumers’ knowledge about the role of nutrition in childrens’ development and the associated health implications. Our findings highlight the importance of understanding the differences in views between different groups of parents and other groups of the population such as teachers to appropriately target public health messages. People’s perceptions of children’s physical or mental development tends to focus on genetics and biological factors but it is also necessary to think of factors influencing general human growth such as the environment and the social context. The first significant result which emerges from our data is that having an interest in healthy eating and higher educational attainment was related to regarding diet as an important influence on children’ mental development. Parents need to be aware of the critical central role that they play in childhood development in terms of nutrition because they shape child-feeding behaviours, , which in combination with genetic and environmental factors help to establish food preferences. In this sense, socio-economic status (SES) is an important factor to be taken into account by researchers when screening childhood dietary quality in so much as it impacts on individual’s social position and can be connected through diverse indicators such as educational achievement, future occupation or income. Socio-economic differences exist in parental lay knowledge about food and SES studies reflect that higher income parents talk about food in relation to health and medical issues. Parents from higher socio-economic areas had better nutrition knowledge than those from areas with lower socio-economic level. Nutrition and dietary behaviours were considered by parents in our study less important factors than sleep, exercise and the school environment for attention and learning. Parents’ nutrition knowledge is likely a reflection of the importance they place on these topics and their interest in health and nutrition. They tend to discuss the effects of diet in terms of long term health and medical outcomes rather than the link between diet and mental performance. A comparison between our findings and those from other studies with consumers reveals that understanding parents’ and teachers’ views of the importance of diet in the mental development of children is essential before developing meaningful messages and dietary change interventions because they have a basic knowledge about what foods are healthy and they expressed an interest and concern about nutrition related to health. On the one hand, the effects of diet during childhood were related primarily to physical development, with positive effects in the long term, rather than cognitive processes like attention or concentration allied to mood and behaviour. On the other hand, negative effects were perceived to be more immediate and short term, and associated with specific foods and nutrients. A possible explanation for this might be that information on food labels and nutrition is an important source typically underutilized by consumers and they need further knowledge on long and short term effects of foods on human development, from childhood to adolescence. Other studies have found parents not to be receptive to interventions aimed at specifically changing dietary behaviour, but are more motivated to engage in healthy behaviours and positive health beliefs within the family setting. This could reflect the need to educate parents to be aware of the effects of foods on mental performace through building public awareness strategies, of nutrition and the health qualities of foods and their effects. These findings of the current study are ancillary with those that reflect the degree of worry that parents can feel about children’s body weight that may sometimes influence them to take steps and, for example, try to prevent obesity in their child. Identifying what factors parents think that may influence childrens’ health is necessary in order to design health care system interventions that will engage parents and motivate them to take action. Effective communication on these topics related to health, and specifically on nutrition, require a basic level of knowledge that the intended audience may be misundertanding. On the question of parents’ food choices for their children, with this study we have found that participants’ decisions about this topic were less influenced by media sources than by health professionals. These results are in contrast with recent studies about the influence of advertising on childrens’ cravings and parents food choices that underline the effects of many factors, including media sources, affecting their relationship with food consumption and their childrens meals demands. In our study parents reported relying mainly on their own experience and common sense so innovative methods of getting messages over may need to be identified. Parental influences on children’s food choices and intake have an effect on individual and family practices, and operate among other mechanisms via availability and accessibility of foods or parental eating behaviour as food modelling. Parents should offer a variety of foods exposing them to healthy food options or serve as role models for healthy eating and active lifestyles. The results in the qualitative work reveal that teachers did not refer directly to the role of nutrition in brain development but they associated diet with both school performance and behaviour. This can be linked to the results in the same research with parents where they spoke in terms of attention and concentration when they were asked about the effects of diet. Teachers in our study perceived that an inadequate daily intake of nutrients from food has an adverse effect on learning, highlighting that it is one of the main reasons for children being distracted and lacking concentration. School staff have been involved in nutritional behaviour studies as assistants, helping medical doctors and psychologists to measure and report some data but they are often in a passive position and do not have an active role in the research. In many of the interviews it became apparent that teachers’ view were influenced by their observations and experiences as parents, rather than their professional training or experience. In educating children about healthy eating teachers strive to promote an ideal optimal nutritional balance, which ensures that children can perform well, both in terms of development and performance. Of the many factors that can influence eating behaviours, a lack of nutrition knowledge is one of the most amenable to change. Comparisons among the four countries in the questionaire revealed significant differences in some characteristics of the respondents’ views, especially among parents. They perceive many factors having an influence on healthy or unhealthy food choices. From our results, the reason for this is not clear but it may have something to do with socio-cultural factors: for example, in Germany providing variety was significantly less important to parents but the most important factor in parents food choice in Spain. It was also shown that, in contrast with results from England or Germany, parents in Hungary generally prioritised elements of mental performance. A comparison with the results from the card sorting study reveals that parents in Hungary attributed greater importance to diet in physical and mental development of their children than respondents in the other countries. This rather contradictory result from the same Project may be due to the kind of methodology applyed for each intervention, emphasising the need of making consumers aware of the positive effects of promoting a healthy lifestyle.