2013. Vol.4, No.3A, 380-388
Published Online March 2013 in SciRes (
Copyright © 2013 SciRes.
Educational Program to Promote the Correlation between
Preference and Food Selection: A Replication Study
María del Refugio López-Gamiño1, Martha Elba Alarcón-Armendáriz1,
Assol Cortés-Moreno2, Xóchitl Karina Torres-Beltrán1
1Grupo de Investigación en Educación para la Salud y Estilos de vida, Facultad de Estudios Superiores Iztacala,
Universidad Nacional Autónoma de México, Tlalnepantla, México
2Proyecto de Investigación en Aprendizaje Humano, Facultad de Estudios Superiores Iztacala,
Universidad Nacional Autónoma de México, Tlalnepantla, México
Received December 31st, 2012; revised January 29th, 2013; accepted February 25th, 2013
Some studies have demonstrated the importance of various factors involved in feeding behavior, although
only a few have focused on the correlation between preference and food selection as an indicator of the
needed skills to interact with the diversity of situations associated with healthy feeding. In a previous
study, performed with 116 Mexican schoolchildren, some changes were observed in the correlation be-
tween preference and selection food, in order to more accurately assess the modified dimensions of feed-
ing behavior, the study was repeated on a different sample. The study allowed us to test a food education
strategy designed to promote four levels of behavioral complexity and their effect on preference and food
selection in a group of schoolchildren. Participants were 298 schoolchildren (141 boys and 157 girls) 6 -
13 years old who were second, fourth or sixth grades and who were assigned to four intervention pro-
grams: noninstrumental situational, instrumental situational, extrasituational and transituational. The ac-
tivities were designed according to the behavioral complexity level. At the start of the intervention, each
participant’s anthropometric measurements were recorded and natural and industrialized food preference
and selection was evaluated at the beginning, at the end and one month after the intervention (pre, post
and follow-up).There were some changes in the children’s behavior of preference and selection, particu-
larly in fourth grade. This underscores the importance of designing educational strategies which promote
the acquisition of knowledge, the development of attitudes towards healthy eating and, above all, effective
and constant practice.
Keywords: Behavioral Intervention; Nutritional Education; Health Psychology; Schoolchildren; Food
Dietary habits are reflected in the health of populations. The
frequent consumption of a proper diet promotes health while
the frequent consumption of a wrong diet alters it. Malnutrition,
overweight and obesity are clear signals of deficits or food
excesses related to wrong food habits, widely linked to a num-
ber of diseases (García-Solís & Aceves, 2005). Dietary habits
are the concrete expression of a number of socio-economic, cul-
tural circumstances and also the concrete expression of the pe-
culiar skills which individuals have, manifesting in the feeding
behavior of each person, ranging from the selection and prepa-
ration of products to the intake in certain combinations and
quantities (Reinaerts, De Nooijer, Candel, & De Vries, 2007).
From the combination of the various factors that affect eating
behavior, since childhood we learn to accept or reject certain
foods. Consumption preferences are determined by early ex-
periences such as the association of food with certain socials
contexts, aversive or pleasant consequences when eating, the
repeated presence of new foods, consumption patterns of the
parents, internal signals (satiety) and external (environmental
“demands”) and availability (Bourges, 1994; Birch, 1998).
Particularly social changes of recent decades have had an
impact on the ways in which families are fed and therefore on
their eating habits, for instance, the fact that some mothers
work outside the home results in the reduction of available time
for the preparation of food with the consequent rapid increase
in consumption of fast food whose salt content, fat and carbo-
hydrates is higher than that a regular diet prepared at home can
contain. The social value that publicity given to certain easily
accessible products (especially for schoolchildren) such as
chips and sweets, alters the balance that must exist in nutrient
intake to maintain an adequate diet.
Food problems in the Mexican population, coupled with their
hereditary characteristics, have resulted in a polarized popula-
tion suffering from malnutrition in addition to overweight and
obesity. These problems have worsened in recent decades both
among schoolchildren and adults (Toussaint, 2000; Ramírez,
García, Cervantes, Mata, Zárate, Mason, & Villarreal, 2003;
Shama-Levy, 2010). The facts are alarming because a signifi-
cant percentage of the population is, from a very early age, at
risk for chronic non communicable diseases such as diabetes
and hypertension, among others.
Several intervention works have been performed in school-
children in order to increase the consumption of fruits and
vegetables, because there is a tendency to reduce the intake of
these foods and to increase the intake of fat instead, which
causes imbalance in the diet. This consumption pattern is char-
acteristic of populations with overweight and obesity problems.
(Seaman, Woods, & Grosset, 1997; Evans, Sawyer, & Betsin-
ger, 2000; Ward, Hoelscher, & Briley, 2002). What children
prefer to consume has also been assessed, and it has been found
that, for example, children under 12 have a high intake of sug-
ary drinks, chips and fatty foods (Douglas, 1998).
If consumption patterns are part of the formation of prefer-
ences, then it is important to facilitate situations where it is
more likely to consume the necessary foods and not just those
individuals most like (Douglas, 1998). This requires that people
have information on how to develop a proper diet; however,
that knowledge alone is not enough. It is also required to de-
velop and maintain feeding behaviors compatible with a healthy
diet. Health education, according to the World Health Organi-
zation (WHO, 1998) is an alternative of intervention not only to
provide information but also to contribute to the creation or
modification of habits in any population.
Dodds, Benedict, Leontos and Krelle (1998) agree that edu-
cation is an alternative to increase the consumption of fruits and
vegetables, which are very important foods in any diet but
which are not enough consumed. They implemented a program
in elementary schools to increase knowledge, to improve atti-
tudes and to promote the consumption of fruits and vegetables
using a combination of educational methods to influence a be-
havior change, from the social learning theory. They found that,
schoolchildren attitudes regarding the acceptance to eat these
foods, improved significantly, as well as their perception re-
garding their ability to eat five fruits and vegetables a day. Be-
fore the intervention, the schoolchildren showed a high level of
knowledge about the benefits of eating fruits and vegetables but
they would not carry it into practice. Although the program
improved attitudes and perception, these authors point out that
it was not possible to measure objective changes in the behavior
of interest.
The specific interventions in health education come from
various theoretical models arising from some disciplines such
as psychology, sociology, anthropology, and marketing. The
interventions are often community, interpersonal and individual
(Pardío & Plazas, 1998). The models most commonly used are
the Bandura’s Social Cognitive Theory and Prochaska’s Stages
of Changes, along with that of Action-Research. For this work
purposes, the health model proposed by Ribes (1990) has been
taken. This model was also used by Cortés , López, Alarcón
and Torres (2009) in a Mexican population. The proposal
claims that the state of health or disease is maintained by indi-
vidual’s behavior, which performs particular competences and
styles to interact within certain situations. The competences
may be available into four different levels of complexity, which
results in the know how to do types: what, how, why, and what
other actions can be carried out under the present circumstances.
The level of behavioral complexity depends on the nature and
degree of participation in Linguistic Conventions.
The authors designed an educational program for each of the
four levels of complexity: 1) Situational non-instrumental: it is
the least complex, the individual only interacts with the situa-
tion without altering the properties of the events (objects, peo-
ple or happenings) that regulate his behavior; 2) Instrumental
Situation: at this level, the individual interacts with the situation,
changing only the immediate context. His responses are effec-
tive to alter the relationship with his environment; 3) Extra-
situational: at this third level, the interaction is modulated by
linguistic behavior because the individual responds depending
on his experience, to circumstances with non-explicit properties
in the current situation; it means that he acts, before a particular
situation, “as if” he had some characteristics of other situation
that is present; 4) Transituational: this level is more complex. In
it, the individual can abstract generic situations in not present
and not momentary situations through his linguistic behavior,
and thus, he faces the situations depending on how he concep-
tualizes them. Table 1 shows an example of the type of pur-
poses and activities that led the intervention.
While the previous application of this model showed that it
affected mainly the preference for natural products and to a lesser
extent the selection (Cortés et al., 2009), it was considered as
relevant to replicate it with another school sample to more ac-
curately assess the dimensions of the modifying eating behavior.
We worked with 298 elementary schoolchildren; boys and
girls aged between 6 and 13 years old, attending a public ele-
mentary school in Mexico City: 106 second grade, 99 fourth
grade and 93 sixth grade. Students were divided into 12 groups,
four per grade, which at the time of the intervention were al-
ready constituted, so that it was possible to assign one group for
each grade and program. Parents accepted their children to
participate in the study and signed an informed consent.
Workbooks on food information (specifically designed for in-
tervention by the researchers) were used. Each workbook with a
different level of functional complexity: noninstrumental
Table 1.
Example of purposes and activities that guided the food education program.
Program Purpose of the activity Example
Noninstrumental Situational Name concepts. Name three foods containing mainly calcium.
Instrumental Situational Select foods acording to the nutrients they contain. Select, from a group of different foods,
those containig more calcium.
Extrasituational Establish effectiveness criteria in the situation,
from previous experiences recovery.
Analize if food eaten the prior day meets the
recommendations of a proper diet.
Transituational Master rules. Develop a scheme to recover the function and
utility of Dietary Guidelines.
Copyright © 2013 SciRes. 381
situational, instrumental situational, extrasituational and tran-
situational. The issues were the same in all workbooks, but the
activities varied depending on the level of functional complex-
ity. The issues were the same in all workbooks, but the activi-
ties varied depending on the level of functional complexity.
Anthropometric measurements of age, weight and height
were taken to all children to get their nutritional status from
tables of the NCHS (National Center for Health Statistics.)
Once the students were assigned to one of the four programs
(noninstrumental situational, instrumental situational, extra-
situational or transituational), they were given a food education
course with the same content, but the activities in the work-
books were according to the level of complexity required for
each program. We also evaluated the preference and selection
of natural and industrialized foods.
Preference assessment and selection of food products were
conducted individually for three periods or phases: before the
intervention (pre), at the end of it (post) and one month after the
post-test (follow-up). Each phase consisted of three consecutive
days. Each child was presented with five natural and five in-
dustrialized food displayed randomly on a table, and then they
were asked to hierarchize them according to their preference,
placing first the most liked and finally the least liked. Once the
products were ordered, schoolchildren were asked to select one
of them for consumption and we handed in at that moment.
Nutritional Sta tus
About 50% of the children had a normal weight according to
the standards applied by the NCHS. The rest was distributed
among underweight, overweight and obesity. As seen in Table
2 the distribution in these three categories was fairly homoge-
neous in the groups we worked with. We should highlight that
about 30% of the schoolchildren fall into the category of over-
weight and obesity.
Table 3 shows the nutritional status of children considering
gender. We found that, compared to girls, a greater number of
boys was underweight or overweight, while more girls were
obese. The differences were not significant. According to the
test JI2 (2 × 4) applied: X2(3, n = 298) = 4.22, p > 0.05.
Preference and Food Selection
Table 4 shows the percentages of preference and food selec-
tion (natural and industrialized) for educational program and
school grade in the three times of the assessment (pre-test,
post-test and follow-up). In general, it is observed that children
say they most prefer natural foods, although they mainly select
industrialized ones. Next we analyze the differences according
to grade and educational program.
Preference/Selection in Second Grade
The four groups showed differences in preference patterns
and food selection before the intervention (see Table 4) al-
though it can be seen that in three of them, children say they
prefer more natural products. In all cases, they select them less
for consumption. In instrumental situational and extrasitua-
tional programs, the selection of natural products remains in a
higher level than that of industrialized ones, but always below
what they say they prefer (see Figures 1-4).
Noninstrumental Situational Program (Second Grade)
Before the intervention, almost twice the number of children
who participated in this program said they preferred natural
products above the industrialized ones, but they chose in the
same proportion the industrialized ones. During the post-test
and the follow-up, the preference for natural products increased
(see Table 4), which was reflected in a greater selection of
natural products, that rose from 33.3% in the pre-test to 50% in
the follow-up (Figure 1).
Table 2.
Percentage of participants according to nutritional status and intervention program.
Program/Nutritional Status Underweight Normal Overweight Obesity
NoninstrumentalSituational 20 48 17 15
Instrumental situational 14 48 18 20
Extrasituational 13 59 17 11
Transsituational 15 47 29 9
Note: Data from anthropometric measurements.
Table 3.
Participants according to nutritional status and gender.
Nutritional status Male (n = 141) n % Female (n = 157) n % All cases n %
Underweight 27 19.1 19 12.1 46 15.4
Normal 67 47.5 83 52.9 150 50.3
Overweight 31 22.0 30 19.1 61 20.5
Obesity 16 11.3 25 15.9 41 13.8
Note: Data from anthropometric measurements taken.
Copyright © 2013 SciRes.
Instrumental Situational Program (Second Grade)
Students who received this educational program showed be-
fore the intervention, similar preference patterns to noninstru-
mental situational program between natural and industrialized
food, although the selection was the same for both types of
products. In the post test there was an increase in the preference
and selection of natural products, and therefore they less pre-
ferred and less select industrialized foods (see Table 4). During
the follow-up, the observed effects in the post-test were re-
versed observed to a level similar to that of the initial assess-
ment, however, the preference for natural products remained at
the level reached during the post-test (see Figure 2).
Extrasituational Program (Second Grade)
In the initial evaluation of this group, as in the previous
group, the most preferred products, and also the least selected
ones are natural products. The preference and selection of natu-
ral products remain above industrialized ones in three phases.
In the case of selection, a phase by phase steady increase of na-
tural products can be observed. After the intervention, the pref-
erence for natural foods decreases slightly, but its selection in-
creases. This effect will be maintained during the follow-up
(see Table 4 and Figure 3).
Transituational Program (Second Grade)
As shown in Table 4 and Figure 4, this group of students
showed equal preference for both types of products in the
pre-test. After the intervention the selection and preference for
natural products improved slightly. This situation was reversed
during the follow-up.
Preference/Selection in Fourth Grade
The four groups of this grade showed in the pre-test very
similar patterns of preference and selection for both types of
products. Like their second grade schoolmates, they chose with
a higher proportion industrialized foods, although there are
differences between the various educational programs (Table 4
and Figures 5-8).
Noninstrumental Situational Program (Fourth Gr ade )
This schoolchildren group shows in the initial evaluation the
biggest preference for natural foods of all groups and grades
(95.06%), as well as a high percentage of selection of the same
foods. As shown in Table 4 and Figure 5, during post evalua-
tion, preference decreases slightly (about 8%), while the selec-
tion is reduced by almost 30%. In the follow-up, besides the
constant diminution of the selection of natural products, the
preference is also restricted, which causes preference and selec-
tion percentages to reverse between the initial test and the fol-
low-up monitoring.
Instrumental Situational Program (Fourth Grade)
In the initial assessment the fourth graders, who participated
in the Instrumental Situational program, most preferred and
most selected natural products than they did in the two subse-
quent phases, however, the difference between preference
(87.21%) and selection (67.06%) is high. Upon finishing the
intervention, the preference for natural products is reduced by
Table 4.
Preference/Choice pretest, posttest and follow up, in percentage.
Grade Noninstrumental Situational Instrumental situational Extrasituational Transituational
Phase Nat Ind Nat Ind Nat Ind Nat Ind
Pre 61.54 38.46 61.25 38.75 73.33 26.67 48.81 51.19
Post 69.23 30.77 75.31 24.69 69.33 30.67 53.01 46.99 Preference
Follow up 71.79 28.21 78.21 21.79 70.27 29.73 46.43 53.57
Pre 33.33 66.67 51.21 48.75 52.00 48.00 35.71 64.29
Post 39.74 60.26 66.67 33.33 57.33 42.67 40.96 59.04
Follow up 50.00 50.00 51.28 48.72 62.16 37.84 36.90 63.10
Pre 95.06 4.94 87.21 12.79 90.91 9.09 86.89 13.11
Post 87.65 12.35 62.07 37.93 96.97 3.03 74.60 25.40 Preference
Follow up 67.90 32.10 77.01 22.99 84.15 15.15 70.97 29.09
Pre 69.14 30.86 67.06 32.94 75.76 24.24 67.80 32.20
Post 44.44 55.56 52.87 47.13 74.24 25.76 55.56 44.44
Follow up 35.80 64.20 54.02 45.98 54.55 45.45 54.84 45.16
Pre 76.92 23.08 89.83 10.17 76.00 24.00 85.90 14.10
Post 78.79 21.21 81.36 18.64 53.33 46.67 84.62 15.38 Preference
Follow up 79.69 20.31 73.33 26.67 45.33 54.67 71.43 28.57
Pre 53.85 46.15 76.27 23.73 45.95 54.05 61.54 38.46
Post 57.38 42.42 57.63 42.37 39.19 68.81 56.41 43.59
Follow up 66.67 33.33 56.67 43.33 41.33 58.67 41.56 58.44
Note: Nat = natural food products; Ind = industrialized food products.
Copyright © 2013 SciRes. 383
Figure 1.
Preference and selection. Situational no instrumental program (second grade).
Figure 2.
Preference and selection. Instrumental situational program (second grade).
Figure 3.
Preference and selection. Extresituational program (second grade).
Figure 4.
Preference and selection. Transituational program (second grade).
Figure 5.
Preference and selection. Noninstrumental situational program (fourth grade).
Copyright © 2013 SciRes.
Copyright © 2013 SciRes. 385
Figure 6.
Preference and selection. Instrumental situational program (fourth grade).
Figure 7.
Preference and selection.Extrasituation program (fourth grade).
Figure 8.
Preference and selection. Transituational program (fourth grade).
25%, as well as the selection which is reduced by 14% (see
Table 4 and Figure 6). During follow-up, preference levels for
natural products recover up to 77%, however, children choose
natural products only in 54% of all cases.
Extrasituational Program (Fourth Grade)
The results observed in the initial test show that schoolchil-
dren chose, at a rate of 3 to 1, more natural products that indus-
trialized ones. This level remains the same in the post-test, and
we can also observe a slight increase in the preference for these
products. During the follow up there was a decrease in the
choice of natural products, with the consequent increase in the
choice of industrial products (see Figure 7).
Transituational Program (Fourth Grade)
Figure 8 shows a steady decline in natural food preference,
between the initial test and the follow-up (86.89%, 74.60% and
70.97% respectively). The same effect is observed in the selec-
tion of natural products, which went down from 67.80% in the
pre-test, to 54.84% in the follow up.
Preference/Selection (Sixth Grade)
Preference/selection patterns that these grade schoolchildren
showed during the pretest were similar to those of their school-
mates from other grades. They generally most prefer natural
products, but at the same time they selected them less, and in
reverse, they claim not to prefer very much industrialized
products but they most often select them.
Nonsituational Instrumental Program (Sixth Grade)
In this group we can observe, in the post test, a slight in-
crease in the selection of natural products, which expands
slightly during the follow-up; although the preference for this
type of products remains unchanged among the three phases of
evaluation. In contrast, industrialized product selection de-
creases phase to phase (Figure 9).
Instrumental Situational Program (Sixth Grade)
In this group, unlike the Noninstrumental Situational pro-
gram group, a decrease in the preference for natural products is
observed from phase to phase, although regarding the selection
of natural products, there is a decrease from 76.27% in the
pre-test to 57.63% in the post-test. No differences in the fol-
low-up (Figure 10).
Extrasituational Program (Sixth Grade)
The group that received this intervention showed a decrease
in the preference and selection of natural products which com-
pared to the percentages obtained in the pre-test was reflected
in the preference increase for industrialized products. In the
follow-up, we can observe how both preference and selection of
the two types of products are stabilized within about 50% (Fig-
ure 11).
Transituational Program (Sixth Grade)
This group, like the first two groups, shows a bigger prefer-
ence for natural products, but a lesser selection of them. After
the intervention no changes in either behavior were observed
(see Figure 12), but in the follow-up we do observe a decrease,
mainly in natural product selection
Differences between Preference and Selection
To determine whether the observed differences between
phases for the preference and selection according to type prod-
uct, degree and educational program, were significant, we ap-
plied a Student’s t-test for related samples, the results are shown
in Tables 5 and 6 respectively.
As for the preference (Table 5) of natural food products, it
can be seen that, in the noninstrumental situational program
there was only significant difference in fourth grade between
the post-test and the follow up; in the instrumental situational
program there was a difference in the second grade between pre
and post-test and between the post-test and the follow-up; in the
extrasituational program in the fourth grade between the post-
test and the follow up; and finally in sixth grade between the
pre and the post-test.
Table 6 shows the results in the selection of natural products.
Significant differences were found in the noninstrumental situ-
ational program with fourth grades from pre to post-test; in the
instrumental situational program, the differences were found in
second grades from the pre to the post-test and from the post-
test to the follow up and with sixth graders from the pre to the
post-test, in the extrasituational program there were significant
differences with fourth graders from the post-test to the follow-
up the post-evaluation
Children in this study reported more preference for natural
foods, but selected industrialized ones; this is consistent with
the study conducted by Cortés, et al. (2009) who found that
individuals show differences in the same direction between
preference and selection of natural and industrialized products.
Furthermore, Dittuss, Hillers and Beerman (1995) demon-
strated the value of nutritional education in a work aimed to
observe changes in the attitudes about the nutritional benefits
and the attributes of fruits and vegetables for cancer prevention,
as well the perceived obstacles in the consumption of these.
They concluded that nutritional education interventions are
Figure 9.
Preference and selection.Noninstrumentional program (fourth grade).
Figure 10.
Preference and selection. Instrumental situational program (sixth grade).
Figure 11.
Preference and selection. Extrasituational program (sixth grade).
Copyright © 2013 SciRes.
Figure 12.
Preference and selection. Transituational program (sixth grade).
Table 5.
Natural food preference by grade and program across measures.
Pre-post Post-follow-up
Program Grade
glt p gl t p
Second 25.86 .40 25 .28 .78
Fourth 261.54 .14 26 3.05 .00
Noninstrumental Situational
Sixth 21.44 .66 21 .29 .77
Second 262.28 .03 26 .00 1.00
Fourth 284.06 .00 28 2.22 .03 Instrumental situational
Sixth 191.56 .13 19 .75 .46
Second 24.46 .65 24 .00 1.00
Fourth 211.45 .16 21 2.16 .04 Extrasituational
Sixth 243.18 .00 24 .84 .41
Second 27.59 .56 27 .96 .34
Fourth 201.37 .19 20 .64 .53 Transituational
Sixth 25.21 .83 25 1.88 .07
Note: Pre-post = pretest-post-test, Post-follow-up = post-test-follow up.
Table 6.
Natural food selection by grade and program across measures.
Pre-post Post-Follow
Program Grade
gl t p gl t p
Second 25 .77 .45 25 1.14 .27
Fourth 26 2.59 .01 24 1.43 .16
Noninstrumental situational
Sixth 21 .55 .59 21 .70 .49
Second 26 2.30 .03 26 3.17 .00
Fourth 28 1.73 .09 28 .18 .86 Instrumental situacional
Sixth 19 2.77 .01 19 .00 1.00
Second 24 .66 .52 24 .57 .57
Fourth 21 .20 .84 21 2.75 .01
Sixth 24 1.15 .26 24 .30 .76
Second 27 .68 .50 27 .60 .56
Fourth 20 .92 .37 20 .19 .85 Transituational
Sixth 25 .68 .50 25 2.00 .06
Note: Pre-post = pretest-posttest, Post-follow = posttest-follow up.
Copyright © 2013 SciRes. 387
Copyright © 2013 SciRes.
useful. These interventions also contribute to make a significant
impact on the healthy food behaviors, first because they pro-
mote dietary changes, such as the increase of consumption of
fruits and vegetables; and secondly, they can also be used to
promote the identification of barriers to healthy behavior and
the alternatives to change it.
In this research, the differences in the preference and selec-
tion of non-instrumental situational programs in all grades, and
extrasituational particularly in fourth and sixth grades, suggest
a possible effect of the educational program, in terms of pref-
erence and selection of natural foods. These effects were ob-
served in the levels of complexity that require more skills re-
lated to the information that the construction of knowledge,
which could be related to the skill level that children would
have at the time of application and the level of skills required in
the activities of the programs.
It is evident that food education plays an important role in
the acquisition of healthy eating habits, and the modification
harmful ones. Shamah and Vázquez (1998) argue that for a
behavior to become a habit, it is necessary to repeat it very
often. From different theoretical perspectives in psychology,
repetition is a fundamental element: for Piaget (1987), experi-
ence is the result of the repeated action with objects. Such ex-
perience becomes a habit that is part of a repertoire that will
incorporate new actions which in turn will be the basis to face
new experiences. For Vygotsky (1979), the child becomes an
expert after performing an activity repeatedly, first with the
help of an adult and then by himself. From the behavioral per-
spective, the increase in the frequency of a behavior indicates
that there was some learning. This increase is mediated by the
reinforcement (Skinner, 1979). For Ribes (1990) interactive
styles are consistent ways of behaving functionally in certain
situations and these are shaped in the psychological develop-
ment process. When acting consistently, the individual is form-
ing his idiosyncratic interactive history, which is a critical fac-
tor for the modulation of their own health or disease.
The feeding behavior can be changed with the acquisition of
knowledge and the development of new attitudes, but mostly
through practice. Shamah and Vázquez (1998) add that the
school is an ideal setting for learning that can serve for the suc-
cessful application of health programs in general and nutritional
programs in particular. The favorable results, regarding the
preference and selection of natural foods which are observed in
some participants in this study, are an indicator of what can be
achieved with the work with schoolchildren, but we must take
into account the characteristics of the population to adjust pro-
grams and thus, to get better results.
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