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Exploring pre-operational and concrete operational children’s thinking on nutrition: A case study

Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, chb24{at}columbia.edu

Tracy H F Chow

Department of Human Development, Teachers College, Columbia University, New York

Objective In this exploratory study, we observed the process in which children make food choices from a cognitive development perspective and the implications that these choices have on the areas of cognitive development and health and nutrition education.

Design This was a cross-sectional case study that involved an in-depth examination of the food choice process and knowledge of a child in the pre-operations stage and a child in the concrete operations stage as defined by Piaget.

Setting This study took place in New York City.

Methods The five general questions on health and nutrition which were posed to each child were: Why do we need to eat? What makes some foods healthy or unhealthy? Can some foods be healthy and unhealthy at the same time? Where do certain foods come from? Why is it important to eat in moderation? The responses to these questions were analyzed from both cognitive and health education perspectives. In addition to being asked questions about nutrition, each in-depth interview included an activity in which the children were given a stack of pictures of foods and were asked to classify them as being healthy or unhealthy.

Results Thelevelofknowledgeandthoughtprocessaboutfoodofachild in the pre-operations stage and a child in the concrete operations stage exhibit several significant differences that are characteristic of Piaget’s stages of cognitive development. Specifically, the depth of knowledge, the use of symbolic thinking, and the abilities to think bi-directionally and systematically, and to view issues from multiple perspectives vary between the two stages.

Conclusion Many of the predictions about how the children would react to certain questions given their age appear to be consistent with the early writings of Piaget. The main implications of these findings could help health educators who focus on nutrition to tailor their educational programmes according to the cognitive abilities defined by Piaget, and reinforced by our findings.

Key Words: cognitive development • food choice • health education • nutrition education

Health Education Journal, Vol. 68, No. 3, 219-231 (2009)
DOI: 10.1177/0017896909346099


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