Sintra Grows Healthy: development and implementation of a food literacy curriculum for primary schools.

Objective: Describe the process of development and implementation of Health at the Table - a food literacy curriculum for primary school aged children.
Design: Through a community-based research process, Health at the Table development and implementation took place in four stages: exploratory study, production, implementation and monitoring.
Setting: Primary schools of Sintra's municipality, Portugal.
Participants: Children (6-10 years), teachers, school staff and children's legal guardians of three primary schools during the pilot project and eight primary schools in the second year.
Results: During the needs assessment phase, 99·1 % (n 341) of the children's legal guardians, 100 % (n 34) of the teachers and 100 % (n 19) of the school staff considered that the school plays an important or very important role in children's food literacy (stage 1). During the pilot project, a manual with sixty session plans was developed (stage 2). In the second year, Health at the Table was implemented by seventy-two trained teachers during one school year (stage 3). Most of the teachers agreed that the curriculum was appropriate (69·2 %) and that children developed health, wellness/well-being and environmental skills (83·1 %). Most of the children said they had learned about healthy eating (86·3 %) and claimed to eat healthier since the Health at the Table implementation (58·9 %) (stage 4).
Conclusions: Health at the Table is a food literacy curriculum that can be reproduced in similar contexts in a sustainable way. The need to combine educational strategies with a healthy school food environment is reinforced to increase effectiveness in tackling childhood obesity.