Theory-informed nutrition education curriculum Tools For Feeling Good promotes healthy eating patterns among fifth grade pupils: cross-sectional study

T. Tilles-Tirkkonen, O. Nuutinen, S. Sinikallio, K. Poutanen, L. Karhunen

    Research output: Contribution to journalArticleScientificpeer-review

    13 Citations (Scopus)


    Background: The eating patterns of school-aged children rarely meet recommendations: meal frequency is irregular and the consumption of vegetables is lower and sugar-sweetened products higher than recommended. Although school is an excellent arena for nutrition education to support pupils eating patterns, teachers usually lack efficient tools. The present study aimed to develop a curriculum for nutrition education to be used by teachers and to examine its efficacy in the school environment with respect to the eating patterns of pupils.

    Methods: The curriculum was developed in collaboration with school teachers using self-determination theory as a theoretical standpoint. The Health at Every Size concept and sensory-based food education were utilised in the curriculum. Self-reported questionnaires were used to assess the feasibility and impact of the curriculum. Fourteen teachers implemented the curriculum during 2012–2013 with 194 pupils aged 10–13 years (fifth and sixth grades). The control schools included 140 pupils of the same age not following the curriculum. Results: The teachers reported that the curriculum was easy to integrate in the school environment. The fifth graders improved their breakfast frequency, increased their consumption of vegetables and reduced their consumption of ice cream, sweets and sugar-sweetened drinks. No improvement was found in the fifth graders at the control schools. In the sixth graders, no dietary changes were detected in the intervention or control schools.

    Conclusions: The pupils in the fifth grade appeared to comprise a responsive target group for nutrition education at schools. The curriculum offers a promising approach for developing healthy eating patterns among fifth graders. Collaboration with teachers in developing the curriculum likely enhanced its feasibility and teacher commitment for implementation.
    Original languageEnglish
    Pages (from-to)647-657
    JournalJournal of Human Nutrition and Dietetics
    Issue number5
    Publication statusPublished - 1 Oct 2018
    MoE publication typeA1 Journal article-refereed


    The study was a part of the ‘Liikaha’ program (funded by the EU, the European Social Fund (ESF) and the Municipality of Sotkamo, Finland), whose personnel we gratefully acknowledge. The authors declare they have no conflicts of interest. This work was supported by the Jenni and Antti Wihuri Foundation, Olvi Foundation and Juho Vainio Foundation (TT-T), the Academy of Finland (KP), and partly by the SalWe Research Program for Mind and Body (the Finnish Funding Agency for Technology and Innovation, grant 1104/10) (LK). The funders had no role in the design, analysis or writing of this article.


    • eating patterns
    • Health at Every Size
    • nutrition education
    • perception of body size
    • sensory education


    Dive into the research topics of 'Theory-informed nutrition education curriculum Tools For Feeling Good promotes healthy eating patterns among fifth grade pupils: cross-sectional study'. Together they form a unique fingerprint.

    Cite this