Supporting a Participatory Process for Evidence on Healthy Eating to Promote Healthy Diet among Children: An Illustration from Nigeria

Objective: In this study, we assessed children’s perception of healthy eating and investigated the contents of lunch boxes packed from home. Methods: Overall, 728 pupils in first to sixth class across 25 primary schools in Ibadan, South West Nigeria wrote their perceptions of healthy eating on small colored papers. Contents of lunch boxes were observed during the school lunch period. Descriptive and qualitative analysis was carried out and data were represented in word clouds and figures. Results: Most pupils (97.9%) listed food items that they referred to as healthy food, represented in a word cloud. Further categorization showed that few pupils identified fruits (5.3%) and vegetables (2.4%) as healthy food. Pupils in private schools were 1.9 times more likely to have pastries in their lunch boxes than public schools (OR = 1.914, 95% CI: 1.121-3.268). Conclusions: Multiple educational interventions should be targeted at the pupil-, parent-, and school-level to promote healthy eating behaviors. The use of communication materials with pictorial depiction of examples of healthy food could serve as a reinforcing factor to help maintain positive behavioral change.