As the director of the Wegmans School of Health and Nutrition, Barbara Lohse is passionate about designing and conducting research that leads to promoting and delivering evidence-based nutrition education. “A few years ago, some research came out that said nutrition education doesn’t work,” Lohse said. “In our group, we knew that is totally not true.”
The problem is that teachers may not use the curriculum properly or at all; they may be too busy or they don’t have the proper resources. So Lohse and her team strive to provide materials that are proven to work and can easily be used by education professionals.
That means designing a curriculum, training teachers to use it with kids and parents, and then evaluating the results to see if the desired outcomes are achieved.
Lohse has established a Nutrition Education Engineering and Designs (NEEDs) Center at RIT, similar to one she founded and directed while on faculty at Pennsylvania State University.
A clinical nutritionist, registered dietitian and professor, Lohse became the first director of the Wegmans School in July 2015. A year later, she received the Society for Nutrition Education and Behavior Research Award for outstanding achievement in the field of nutrition education.
Lohse’s research efforts focus on three tracks that are interrelated: educating parents and children so they have a healthier lifestyle; eating competence; and feeding dynamics.
Building on her research at Penn State, Lohse and RIT Assistant Professor Elizabeth Ruder recently launched a curriculum called “NEEDs for Tots” at the Volunteers of America (VoA) in Rochester. They conducted a training session in September for teachers at the Head Start program at the VoA. Funding for this project is provided by a $5,000 grant that Ruder was awarded for a proposal she wrote as a participant in RIT’s annual Grant Writer’s Boot Camp.
The focus of the VoA program is to educate preschoolers and their parents on ideas of how to have a healthier life, with nutrition as the entry point. Teachers use colorful illustrated children’s books, such as one titled The Cow Loves Cookies. “It has to do with the idea of celebrating our love of food, and feeling good about eating and good about eating foods we like,” Lohse said.
Physical activity also is a component. “The book is all about how the different animals show they like to eat,” Lohse said. Illustrations show birds flapping their wings and pecking, for example.
Each preschool teacher at the VoA received a kit that includes all the handouts, books, shelf-stable foods, and even bowls for the food, so the teachers have everything they need. One tasting activity is centered around a book in English and Spanish called Let’s Eat! ¡A Comer! that teaches about mealtime. A meal time is defined as a family sitting at a table, facing each other, and eating the same foods. The parent isn’t talking on a cell phone and the child isn’t watching TV.
As a complement to the book, children get to taste whole wheat tortillas, spreadable cheese, pinto beans, and green chilies. “So kids have the opportunity to taste this food, and they also have the opportunity to practice learning how to decline a food, if it’s not something they care to try, and learn how to do that politely,” Ruder said.
There are also activities for parents to do at home with their children. Both teachers and parents are surveyed at the start of the program and at the end. The surveys are meant to measure changes in behavior and get feedback from teachers and parents to the curriculum.
“We’ve tested this (program) in 30 different preschools in Pennsylvania and in two different waves, so we’ve been able to modify and change things,” prior to bringing it to the VoA, Lohse said.
The study at the VoA also will examine how teachers and parents approach feeding children based on a concept called “the division of responsibility in feeding,” developed by Ellyn Satter, an internationally recognized expert on eating and feeding.
The idea is that the parent’s job is to provide healthy foods in satisfying amounts in an environment that’s conducive to eating, with adults and children eating together, no TV in the room, and so on, Lohse said. The child’s job is to decide if s/he wants to eat and how much s/he wants to eat. “The parent doesn’t determine if the child puts food into their mouth. The parent doesn’t determine how many bites they take or how many helpings; that’s the child’s responsibility.”
Lohse gives the example that adults would be repulsed by the idea of eating worms or dirt, but that’s how a child might view a certain food, like chicken. But children naturally want to please their parents, Lohse pointed out, so if the child sees the parent eating chicken and enjoying it, “over time, they will start to eat it, and that’s clinically been proven. We’re working on proving it research-wise.”
This ties back to all that coaxing parents use to get their children to eat. The division of responsibility in feeding goes counter to those social norms. Rather than trying to persuade their kids to try a bite, parents should always have some food on the table that they know their child likes, such as applesauce or bread, so the child does eat something, Lohse said.
While at Penn State, Lohse and her research team videotaped 20 families eating a meal and then surveyed the parents about their eating dynamics; they also surveyed 100 more parents who weren’t videotaped. The study measures quality of life; childhood nutrition status; the parent’s eating competence, role modeling and approach to eating; and food insecurity, and compares those to feeding dynamics.
While the data analysis isn’t complete yet, Lohse said it does show that if parents follow proper feeding dynamics, their children are healthier and have a higher quality of life.
There’s a payoff when children get active in the kitchen, Lohse has found. She has been working with Dr. Leslie Cunningham-Sabo, an associate professor at Colorado State University, and Ruder on a program with fourth-graders in Colorado. The study is in its fifth and final year, so the group has data from four years of working with fourth grade students and their parents.
The yearlong program measures whether teaching children to cook influences their fruit and vegetable preferences, their feelings of self-efficacy for preparing food, and so on, Lohse explained. “Our preliminary data show that we are really having an impact. ... We’re seeing an improvement in (food) preference and an improvement especially in kids who had no cooking experience beforehand (especially boys). We feel cooking experience is important because a lot of families don’t cook. A lot of kids don’t know how to cook. They have no idea you can actually make something, not just buy it” already made.
She believes these lessons fill the gap created by schools abandoning home economics classes, and they help to reduce childhood obesity. “If you overlay the childhood obesity problem on the removal of home economics, it’s almost a perfect overlay.” The lessons also have an online component for parents, called “About eating,” which is available from the NEEDs Center website.
This research ties into the idea of eating competence (an intra-individual approach to eating), a construct also developed by Satter. “We have done a lot of research where we have seen that if you have an eating competence approach, you actually have better sleep hygiene, fewer cardiovascular risk factors, healthier BMI (body mass index). You’re more physically active; you have higher dietary quality,” Lohse said.
In a nutshell, eating competence means “you give yourself permission to eat what you want but you discipline yourself so you are eating routinely and regularly in amounts that are satisfying and healthy for you.” Lohse wants to implement the Colorado program in Rochester. As a first step, Lohse just completed surveying fourth-graders and their parents in city schools about physical activity.
Lohse’s research and development of materials tie in well with RIT’s emphasis on digital resources. Lohse recognizes that smart phones, tablets, and social media are vital tools to reach a target audience. For example, “ne/Frames” (nutrition education frames), available online from the NEEDs Center website, can be shown on any screen in PowerPoint, jpeg, video stills and video animated format. The frames cover topics such as diabetes, sodium, fiber, herbs, child activity and more—with many available in Spanish. Prior to launch, each frame was shared with the intended audience and revised based on their feedback before being posted on the website.
Much of Lohse’s research during her career has focused on low-income populations. “I grew up in Minnesota and found there were a lot of poor families around. I just always was struck by ‘how do they eat?’ I was interested in nutrition and learned that poor families have a lot more problems with nutrition.” Back then, the focus was on malnutrition; today it’s on obesity, Lohse explained. While at Penn State, Lohse oversaw the SNAP-Ed program for the state, which provided nutrition education for people eligible for SNAP (formerly known as food stamps).
Lohse wants the federal government to make materials that promote positive feeding dynamics available to federally funded programs, such as child care centers, schools, and WIC (Women, Infant and Children) supplemental nutrition programs.
Lohse has connected with researchers from around the world who are doing eating competence research. “We’re trying to create a critical mass of researchers who feel the same way and we stop all this craziness about here’s this diet, here’s that diet, eat carbs, don’t eat carbs, eat nuts, no, don’t eat nuts.”
The ultimate goal for Lohse? “To help people to be better friends with food.”