Education in Nutrition in Schools
Schoolchildren in Western countries received simple instruction at school on the rules of health, and it seemed to be essential that such teaching had to include instruction on diet, a variable subject closely dependent on cultural habits, which differed from country to country. Therefore no general rules were able to be adopted regarding the type and amount of instruction in nutrition, nor which schoolchildren should receive it. Simplicity was considered a good principle, in order to avoid the impression that correct feeding was a difficult problem. The main advice was that elementary principles were transmitted about the composition of the diet (such as green vegetables are healthy foods). School meals were an excellent opportunity to instruct children in the principles of the new science of nutrition. The supplying of milk was also able to help teachers inform children and parents about its nutritional value.
The nutrition class was also conceived for malnourished children. Work with outpatient children gave evidence of the existence of a large number of delicate children, belonging to all social classes, who appeared to derive little benefit from ordinary medical treatment. Dr. Emerson, working in a clinic in Boston, confirmed this impression by studying 5,000 children attending the clinic. He chose 15 children who showed marked evidence of debility and malnutrition, and put them together in a class for treatment by education in nutrition. Children attending this nutrition class were given a notebook in which to record the nature of meals and their duration, hours of sleep, and the amount of time spent playing in the open air. At the same time, a nurse or social worker visited their homes and surveyed the hygiene conditions in which each child lived.
Similar to other school cards used by medical inspectors to record physical features and clinical examinations, each child was presented with a chart bearing its name, on which two curves were inscribed, one representing the child’s actual weight curve and the other an ideal weight curve. The children themselves recorded their weight week by week on the chart, and their parents were invited to attend the class in order to share and assume the content of the programme. Some sort of reward was given to children who made the best progress. If a child was not progressing favourably, an attempt was made to discover the reason: lack of sufficient food, too easy and rapid meals, faulty hygiene or infectious conditions. The parents were informed of the cause of the child’s lack of progress. Initially, nutrition classes were attached to clinics, but they were subsequently developed in schools as an activity associated with medical school officers. They were sometimes supplemented by open-air “nutrition camps”. “The nutrition class involves an abridgment of school-hours. The program includes a rest and a meal at 10:30, half an hour’s rest before the midday meal, and a small meal in the middle of the afternoon”.
The results obtained were apparently very positive. Burnet and Aykroyd cited some reports assessing the result of nutrition classes during the period 1921-26, stating that 80 per cent of children attending the class regained average weight, while only 35 per cent of poorly nourished children outside the classes made similar gains during a similar period. It was claimed that the beneficial effects of the nutrition class extended to children not actually enrolled and to the children’s homes. Similarly, the London County Council Education Committee established five nutrition clinics in London at the end of the 1930s. Medical intervention was widened and suitable cases were referred to those clinics by school doctors, teachers and child care committees.
Each child underwent a medical examination to ascertain whether he or she was suffering from a nutritional deficiency. If that were the case, advice was given to the parents and, when necessary, treatment was provided in the form of a specific diet rich in cod-liver oil, iron, proteins, etc.15