Sub theme 1: Students’ understanding preferences

The data analysis shows that students and teachers from all types of primary schools believe that unhealthy food is very tasty. Teachers believe that the first reason for students’ choice of unhealthy food is taste. During the observation I noticed that the children were eating unhealthy food and sharing it with friends. They enjoyed it and thus it has an effect on their choice of food, as quoted below.

“I noticed many of the students enjoyed eating fried potatoes in small cardboard in the schoolyard”

(Field notes, Private School)

“The students’ health in general is good. However, we feel sorry that the students love fast food too much and they do not buy the health food available.”

(I3T1. Teacher Interview, Islamic school)

“The students knew that some types of food increased their body weight and still continued to eat them. Moreover, they knew that they eat unhealthy food just because they like that type of food. They are

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afraid to talk about unhealthy food with anyone because they think that that person will stop them from eating it.”

(AT1. Teacher Interview, Public school)

“Some of the students focus on fast food such as; beef burgers, fried chicken, and all fatty food. Some of them have unhealthy pattern because they depend on ready food which is not useful to their health”

(PT3. Teacher Interview, Private school)

“The majority of the students in the school decide to spend less money on sandwiches and juices. Their money is spent on fried chips, sweets and other unhealthy foods. They spend much money buying unhealthy food because it is sweet and very tasty.”

(AT1. Teacher Interview, Public school)

Many students mentioned that they like to eat fried chicken because it is tasty and one of them mentioned that healthy meals are delicious meals, but he mentioned fast food as an example, as quoted below.

“The healthy food is tasty such as fried chicken.”

“I like to eat fried chicken and fruits“

“I like to eat Kabsa (rice with meat) and fried chicken“

“The fried chicken is very tasty; however, doctors’ advice is not to eat fried chicken more than once a month”

(Student Interview)

The second reason is that many teachers attributed the students’ choice of unhealthy food and their poor health behaviour to the fact that they are still children. Some of the teachers

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mentioned that students’ unhealthy behaviour will change by the time they reach the next school level, as quoted below.

“The students in this level do not pay attention to body weight. This idea will not cross their mind. However, this can happen at the next school level such as intermediate and high school.”

(IT1. Teacher Interview, Islamic school)

“The students at these levels I think they understand obesity in general, but they do not understand the context of obesity and its causes. I never hear them say this word in school.”

(BT1. Teacher Interview, Public school)

“What I think is that the students will mention sports with regards to maintaining their body weight, but they will not mention eating. They have no deep background about this topic and so cannot control themselves at this age. Therefore, when they feel hungry they will eat whatever is in front of them, healthy or not.”

(I2T2. Teacher Interview, Islamic school)

“It is difficult for the student who is 12 years old and under to be aware of the link between body weight and his health. He is not aware yet.

That is why he is not concerned about increasing his body weight or not.”

(P2T2. Teacher Interview, Private school)

However, the student interviews revealed that fourteen out of thirty-three students who participated in this study asked for support to help them to reduce their body weight, whereas, only two students asked for help to increase their body weight.

173 “Yes, I want to be skinny, skinny too much.”

“Yes, I want to increase my body weight a little bit.”

(Student Interview, Islamic school)

Teachers believe that the third reason contributing to the students’ choice of unhealthy food is that students have a limited understanding of obesity. An interesting point coming from teachers’ interviews is that they focused on students’ limited understanding and not on their responsibilities or the curriculum with regard to increasing students’ awareness. For example, students are not aware of factors that lead to obesity, as quoted below.

“The children know that obesity is connected with overeating. But they are not aware of the other factors which may affect their health, such as, physical activities and the health issues in the food, such as, quality and the variety of food. The students will go back home from the school, they will find their lunch is ready, then they will eat and sleep and they don’t know that this behaviour can affect their body weight.”

(AT2. Teacher Interview, Public school)

“Obesity is a disease which makes humans obese and they cannot move quickly. The cause of obesity is eating harmful food such as uncovered food and low useful food and drink soft drinks”

(IS3. Students Interview, Islamic school)

“Those students, who are not aware of health, they do not understand obesity and they are not aware of its complications. Sometimes, the student does not choose a good meal to eat; for example, he chooses to eat high fat food.”

(PT1. Teacher Interview, Private school)

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“Obesity is a disease that comes to humans because of overeating and they eat fat food, and the effect of obesity is swelling of the human.”

(PS3. Students Interview, Private school)

“I expect that the students know about obesity but they have no deep understanding about that. Therefore, they do not know that obesity is the accumulation of fat in the body and it can affect arteries. All they know is that obesity is increasing body weight.”

(I2T1. Teacher Interview, Islamic school)

“Obesity is an increase of body weight and it is not good that a person uses medicine to reduce obesity because this is a big mistake. I mean, they should use medicinal herbs better because it is safe.”

(GS4. Students Interview, Public school)

In support the above statement, whilst I was walking outside the public school I saw that the students had started their physical exercise session. The children were playing football but spent a lot of time complaining to each other instead of doing the exercises. The problem is that there was no teacher interested enough to guide them in their sports session; not even the sports teacher, as quoted below.

“I heard sounds coming from school playground. When I went there, I saw students playing football and there was no teacher was watching them. Their noise level was very high and indicated dissatisfaction with play. They spent lots of time talking to each other to solve the

problems. When I talked to the teacher about the situation he replied

‘do not worry! They are kids and this is normal because children do not accept a result from each other quickly.’”

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(Field notes, Public School)

Moreover, in order to understand the students’ knowledge about body weight, I asked them three questions - what advice would they give people who want to maintain, reduce and increase their body weight? Fourteen students from the student interviews advised people to eat everything when they wanted to increase their body weight, as quoted below.

“Eat, for example, rice with meat, pasta, and drink Pepsi, soft drinks to increase body weight.”

“To increase body weight drink soft drinks, eat fried food, eat a lot of food.”

(Students. Interview, Private school)

Furthermore, I designed a children’s pamphlet to encourage them to interact with me in the interviews. From the literature I asked three questions which had not been asked in previous studies, I asked the children. ‘What advice would you give to people who want to increase their body weight?’ Twelve students advised people who wanted to increase their body weight to eat unhealthy food, even if it was harmful to their health, as quoted below.

“Eat a lot of unhealthy food and little healthy food.”

“Eat in restaurants because the sandwiches from restaurants are always harmful.”

“To eat sweets and oils- I mean to eat everything with oils and sweets and chocolate.”

(Students. Interview, Private school) “Eat unhealthy food such as sweets and soft drinks”

“Eat fatty food such as burgers, fried chips, artificial food and sweets.”

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“Overeating, drinking soft drinks, fried chips, do not play sports and stop walking”

(Student Interview, Islamic school)

“Eat much sweet and eat fast food”

“Overeating, eat fatty food and stop doing sports”

“Drink soft drinks, eat sweets, overeating”

(Students. Interview, Public school)

Summary

From the above discussions, it is clear that the teachers believe that students seek out tasty food regardless of whether it is healthy or unhealthy food, and they referred to reasons such as student age. Students’ understanding preferences can have an impact on two clusters of the Foresight Obesity System Map, which is food consumption cluster, and social psychology cluster. For example, the palatability of food offering in schools is related to food consumption cluster, as shown in the diagram below.

In primary school students are not yet capable of understanding everything related to health.

The fact is that the students need more education to increase their understanding of healthy The food consumption cluster

Students’ understanding preferences

The social psychology cluster Palatability of food

offering

Education Media availability

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food and body weight. Also, schools should establish a school health policy and guidelines.

Moreover, teachers need to understand their role in student health.