Impact of a traffic light nutrition tool in a primary school.

Aims: To evaluate the impact of a school traffic light nutrition tool on the knowledge, attitude and behaviour of Key Stage 1 children (aged five to seven years). Methods: A school traffic light nutrition tool is created, adopting the principles advocated by the House of Commons Health Select Committee on Obesity,(1) which seeks to encourage children to freely eat green food, eat amber food in moderation and stop and think before eating red food. A single sample pre- and post-test design is used to measure changes in children's knowledge, attitude and behaviour. A state primary school in the UK, located in an area of mixed private and social housing, with a non-selective admission policy is the setting for the study. In total 69 children, aged five to seven, were tested three weeks before and three weeks after nutrition education. Results: Knowledge improved significantly following nutrition education. Positive attitude scores and asking behaviour for red food decreased, but disappointingly positive feelings and asking behaviour for green food also diminished. Children's refusing behaviour for red food increased. Conclusion: Beneficial changes in knowledge, attitude and behaviour were observed, but negative changes in attitude scores and behaviour towards green food suggested that children misunderstood some nutritional messages. A lack of wider school involvement and only the partial support of parents weakened the effectiveness of this approach. The nutrition tool is cost neutral and may have applicability in other settings.