Encouraging Healthy Eating in Children with the Food Dudes Programme
Submitting InstitutionBangor University
Unit of AssessmentPsychology, Psychiatry and Neuroscience
Summary Impact TypeHealth
Research Subject Area(s)
Medical and Health Sciences: Public Health and Health Services
Summary of the impact
The Food Dudes scheme devised by the Bangor Food and Activity Research
Unit has produced large and lasting increases in children's consumption of
fruit and vegetables. More than 500,000 4- to 11-year-old children have
participated, in European countries and the US, with funding of more than
£20m for research, evaluation, and rollout. Given the major public health
challenge of increasing children's consumption of fruit and vegetables
(often their least-liked foods), in order to reduce potential risk of
future obesity or illnesses including diabetes, cardiovascular disease and
some cancers, our unique combination of behaviour change principles --
including Role Modelling, Rewards, and Repeated Tasting -- has achieved
School-based, health nutrition interventions that inform children why
they should eat more fruit and vegetables have often failed to produce any
lasting increases in consumption of these foods. To investigate whether a
behaviour-change approach might be more successful, Professors Lowe and
Horne (at Bangor since the 1980s) launched a strand of translational
research, funded initially by the ESRC (Nation's Diet Initiative) and
Unilever, in the first half of the 1990s. Whereas the research literature
on food preferences suggested that repeated tasting could increase
children's liking of some novel foods, there was no reliable means of
establishing the crucial taste exposures to fruit and vegetables.
Lowe and Horne first conducted a systematic investigation of the separate
and combined effects of Rewards and Role Modelling on consumption of fruit
and vegetables in 5-7-year-old "fussy eaters" at home. Role modelling was
provided by a video, created by the Bangor team, showing four fictional
child characters, the Food Dudes, happily eating fruit and vegetables,
"the source of special energy they needed to defeat the forces of evil".
The combination of Rewards and Role Modelling produced large and lasting
increases in children's consumption of targeted fruit and vegetables,
effects that generalised to other foods in those categories. Rewards alone
had some effect, but mainly for fruit consumption; Role Modelling on its
own had no effect. This research identified a unique and powerful synergy
— the combination of Rewards and Role Modelling had effects that far
exceeded those of either variable on its own [3.1]. This is because
Rewards "from the Food Dudes" signify to the children that they have
achieved approval from, and membership of, a successful and inspirational
group of peers. The symbolic context of the Rewards determines both their
potency and durability as incentives for behaviour change. The Food Dudes
intervention enables children to repeatedly taste novel foods, discover
their intrinsically rewarding properties, and develop a lasting
liking for them, thereby maintaining the change in eating behaviour over
In the late 1990s, this new behavioural intervention was taken to scale
over a series of studies, first with classes of 5-7 year olds in local
primary schools. From 2000, with funding from Industry, a whole-school
intervention was developed and trialled successfully in UK primary schools
[3.2, 3.3]. This "Full Force" Programme was then modified for countries
such as Ireland, where schools do not provide food at lunchtime, and to
influence parents to provide fruit and vegetables in their children's
lunchboxes. In autumn 2007, following a successful controlled trial [3.4],
and a World Health Organisation Award (2006), the Irish Government decided
to roll out the Programme to all primary schools in Ireland. UK regional
rollouts followed in 2009, and trials are on-going in Italy [5.4] and the
A range of new principles from cognitive psychology and behavioural
economics have been incorporated into the research, and new programmes
have been trialled that: (i) maintain the school healthy eating culture
year-on-year, with an increased focus on catering ("Food Dudes Forever");
(ii) increase children's fruit and vegetable consumption in Special
Schools [5.6] and Nursery Schools [3.5]; and (iii) raise levels of
physical activity [3.6].
References to the research
Note: For each publication listed below, authors other than Lowe
and Horne were either postgraduate students or research assistants in the
Bangor Food and Activity Unit at the School of Psychology, Bangor
University, at the time the research was conducted. * indicates
outputs that were returned in RAE 2008. Citation counts (October 2013) are
from ISI Web of Knowledge unless otherwise indicated.
3.1. Horne, P. J., Lowe, C.F., Bowdery, M., & Egerton, C. (1998). The
way to healthy eating in children. British Food Journal, 100,
133-140. (34 citations in Google Scholar). DOI:10.1108/00070709810207496
3.2*. Horne, P. J., Tapper, K., Lowe, C. F., Hardman, C. A., Jackson, M.
C., & Woolner, J. (2004). Increasing children's fruit and vegetable
consumption: a peer-modelling and rewards-based intervention. European
Journal of Clinical Nutrition, 58, 1649-1660. (56 citations).
3.3*. Lowe, C. F., Horne, P. J., Tapper, K., Bowdery, M., & Egerton,
C. (2004). Effects of a peer modelling and rewards-based intervention to
increase fruit and vegetable consumption in children. European Journal
of Clinical Nutrition, 58, 510-522. (62 citations).
3.4. Horne, P.J., Hardman, C.A., Lowe, C.F., Tapper, K., Le Noury, J.,
Madden, P., Patel, P., & Doody, M. (2008). Increasing parental
provision and children's consumption of lunchbox fruit and vegetables in
Ireland: the Food Dudes intervention. European Journal of Clinical
Nutrition, 63, 613- 618. (19 citations). DOI: 10.1038/ejcn.2008.34
(submitted to REF2014 ID 0425).
3.5. Horne, P.J., Greenhalgh, J., Erjavec, M., Lowe, C.F., Viktor, S.;
& Whitaker, C.J. (2011). Increasing pre-school children's consumption
of fruit and vegetables. A modelling and rewards intervention. Appetite,
56, 375-385. (8 citations). DOI: 10.1016/j.appet.2010.11.146
3.6. Horne, P.J., Hardman, C.A., Lowe, C.F., & Rowlands, A.V. (2007).
Increasing children's physical activity: a peer modelling, rewards, and
pedometer-based intervention. European Journal of Clinical Nutrition,
63, 191-198. (12 citations). DOI: 10.1038/sj.ejcn.1602915
Overall funding specifically for research on the Food Dudes scheme
1995-2013: Total ~£4.5m from multiple sources e.g. UK Government, NHS,
local authorities, and private and third-sector industry.
Details of the impact
Impacts on eating habits of children and parents
Internationally, over half a million children from diverse social,
economic, and ethnic, backgrounds have taken part in Food Dudes since
2008, with full evaluation in 25%. As in our proof-of-principle research
[3.2, 3.3, 3.4], the rollout Programme produced large and significant
increases in fruit and vegetable consumption [5.1, 5.2, 5.6, 5.7]. Effects
were even bigger in children who ate the least before the intervention,
showing that inequalities in children's diets were addressed [5.7].
Twelve months after the Programme in the Ireland study [3.4], parents
were still providing 93% more fruit and vegetables and children's
consumption had increased by 90%, relative to baseline, adding two
child-sized portions of fruit and vegetables to their daily diets.
Following this successful study, from October 2007 the Irish Government
began a 7-year Food Dudes rollout to their primary schools:
419,000 children have participated so far, and independent evaluations
report reliable increases in consumption following the Programme [5.1].
Impacts extend to the home. Parents report that their children asked them
to buy more fruit and vegetables following the Programme; parents
also increased their own daily intake of fruit and vegetables [3.2, 3.3,
3.4, 5.6, 5.7]. A 20% decrease in children's consumption of
calorie-dense snacks was also reported in UK regional rollouts [5.6, 5.7],
and Italy trials [5.5]. Parents and teachers also reported this impact on
their own diets [5.6, 5.7].
Children with learning difficulties are particularly susceptible to poor
dietary habits and obesity. In our 2012 Special Schools trial (N=248),
fruit and vegetable consumption increased and unhealthy snack consumption
Rollouts of the Food Dudes programme
The Ireland national-rollout team serve as international ambassador and
mentor for the Programme. In 2009/2010, Wolverhampton Primary Care Trust
and Italian researchers visited Irish schools to observe the Programme's
impact on children's fruit and vegetable consumption and to learn the
logistics of large-scale implementation — knowledge that was
shared with other UK commissioners [5.6, 5.7].
Recognising the potential impacts of increased fruit and vegetable
consumption at the population level, the UK fruit and vegetable industry,
including 7 major UK supermarkets, multinational companies [5.3], and
government agencies, have provided funding and on-going (2008-present)
support for the Programme.
The Food Dudes in England Collaborative Group was formed in 2008. With
representatives from the Bangor Food and Activity Research Unit, the
School Food Trust, and the Horticultural Development Council, its
objective is to promote rollout of the Programme in England. Our
researchers have presented the Programme's extensive evidence-base to
Industry and Government departments in many other European countries, and
in the US.
Companies in Ireland have accrued substantial economic benefits over the
roll-out duration. Increases in turnover are: Real Events Solutions
[Programme delivery] = €6,366,648; Giraffe [Programme materials] =
€5,307,215; Pallas Foods [Fruit and Vegetable supply] = €7,181,614; Video
Company [Food Dudes DVDs] = €166,223; jobs created = 13 full-time and 40
part-time posts, maintained annually to deliver the rollout.
The Irish Government has spent €19.3 million on their Food Dudes
Programme, demonstrating a strong impact on national public policy and
services [5.1]. Extensive take-up by UK NHS Trusts and Local Authorities
(investments of £1.9m, £1m respectively) demonstrates a policy shift
towards behaviour change interventions, away from health education
The UK Conservative Party Policy Green Paper, "A Healthier Nation",
highlights Food Dudes as "a good example of how many of the
characteristics of successful behaviour change programmes can be
incorporated in a single highly specific initiative" [5.9]. DEFRA's First
Report from the Council of Food Policy Advisors (2009; p13) recommends
that "If evaluation shows long term benefits, extend the `Food Dudes'
healthy eating programme for children".
Lowe and Horne were advisors in 2007 to the EU's €90 million European
School Fruit Scheme; Lowe subsequently became the current Deputy Chair of
the Scheme's Scientific Expert Panel. The Scheme now promotes
take-up by Member States of recommended evidence-based interventions,
including the Food Dudes. This provides an excellent opportunity to extend
the Programme throughout Europe. Since 2008 the EU (DG AGRI and DG SANCO)
features Food Dudes within their healthy eating policy.
In 2012, responding to a rapid escalation in demand for the Programme,
Lowe and Horne — in partnership with Bangor University — established Food
Dudes Health Limited, a spinout company with a new corporate website. In
doing so, 20 new jobs were created. This Social Enterprise has developed
new Food Dudes programmes and, by attracting further research funding from
a variety of sources, scaled-up their delivery to improve children's
health and wellbeing globally.
Media and Awards
Food Dudes has attracted increasing media attention: ITV's Tonight
programme "Obesity the Time Bomb" (23/2/2012) received 30,000 more views
than their average (17% of the viewing population watched). And a Guardian
article (9/8/2010) argues for Food Dudes in every UK school.
The Programme's health impacts have been recognized by 8 prestigious
awards, among them:
Social Marketing Showcase Award (2009), UK Chief Medical Officer's Gold
Medal Award (2010), Society for the Advancement of Behavior Analysis
(ABAI) Award for Translational Research (2012; 5.10), and Local
Authorities Research Intelligence Association (2013).
Sources to corroborate the impact
5.1 Testimonial 1: Head of Division, Department of Agriculture, Food and
Marine, Ireland, responsible for Food Dudes national rollout to Irish
primary schools (target = 500,000 children).
5.2 Testimonial 2: Health Improvement Specialist; Wolverhampton City
Council, responsible for delivering Food Dudes programme to all primary
schools in Wolverhampton (20,000 children).
5.3 Testimonial 3: Research & Development Director, Unilever,
specialist in behaviour change.
5.4. Wengreen, H. J., Madden, G. J., Aguilar, S.S., Smits, R. S., &
Jones, B. A. (2013). Incentivizing children's fruit and vegetable
consumption: Results of a United States pilot study of the Food Dudes
Program. Journal of Nutrition Education and Behavior, 45, 54-59.
5.5. Presti, G., Cau, S., & Moderato, P. (2013). Changing the way our
children eat: a behaviour analytic approach. Progress of Medical
Sciences [Postępy Nauk Medycznych], 26, 28-34. A copy is available
5.6. Walsall Commissioner's Evaluation Report, including Midlands Special
Schools Trial, (2012). A copy is available on request
5.7. Wolverhampton PCT Commissioner Report on Impacts of the Food Dudes
programme, (2009). A copy is available on request
5.8. Industry support: Article in Horticulture Week (20th
August, 2010) "Government urged to extend Food Dudes scheme across
England primary schools". Available as a pdf copy or at:
5.9. UK Conservative Party Policy Green Paper No 12, "A Healthier
Nation": Food Dudes highlighted (Case Study 4.7) as "good example of
how many of the characteristics of successful behaviour change
programmes can be incorporated in a single highly specific initiative".
5.10. Society for the Advancement of Behavior Analysis Scientific
Translation Award to recognize 22 years of behaviour change research
by Horne and Lowe in the domain of applied children's food preferences,
and its successful national and international translation. Presented
before audience of 4,000 delegates at the Annual International Association
for Behavior Analysis conference in Seattle, May 2012. A copy is available