"Ditch the Fizz" is the simple but highly effective slogan of a health education project for primary pupils - linked with a reasearch study - that has been very successful in preventing childhood obesity. Using raps, art and quizzes, staff from the Royal Bournemouth Hospital and teachers from six Christchurch primary schools worked together for a year to deliver the message that fizzy drinks are unhealthy.
"As they get older, children consume more and more of them, with devastating consequences," explains Janet James, the specialist nurse who led the project. "In theory, one can of fizzy drink a day could add 50kg in weight over 10 years and there is a close link between obesity and type 2 diabetes."
The results of the study were startling. Children were divided in to two groups; control and target. Those in the target group decreased their intake of fizzy drinks while those not involved increased their intake.
Over the year, the percentage of obese pupils in the control group rose by 7.5 per cent, while the proportion of excessively over-weight children in the target classes fell slightly.
"It is hugely worrying that obesity rates went up so significantly in the control group," says Janet. "But the research also shows that small changes can have a huge impact and that schools have a vital role to play."
For their part, the teachers involved are convinced that bringing in health professionals has had a big impact on pupils' attitudes.
"As a nurse, Janet had more credibility," says Ceri Edwards-Hawthorne, a Year 5 class teacher at the Priory CofE Primary School in Christchurch, whose pupils composed a winning Ditch the Fizz rap. She also found that up-to-date information on diet and health issues gave her added confidence to reinforce the project's message: "We get so many conflicting messages and things change so quickly - are potatoes on or off? Should it be three square meals or regular snacks? It was good to get something hot from the press."
Ceri believes that the project was effective partly because it was child-centred. The medical team initially worked with a music teacher to compose a rap attacking fizzy drinks. The children were then encouraged to compose their own versions for a competition, and the Priory Year 5 class held a Eurovision-style contest to pick the rap they wanted to enter.
Janet thinks the simplicity of the message is another reason for the project's success. "It's important to give children one very clear-cut, concise message - don't drink fizzy drinks," she stresses.
Janet spent the first of three one-hour sessions with classes talking about healthy eating and promoting water as a healthy drink. She also explained how sugary drinks cause tooth decay, and left a tooth immersed in cola for each class to observe: "The effects are really gross - the tooth loses its enamel and goes black and smelly - but I found that the gory details really got the message across." Pupils also sampled exotic fruits, to show that food can be naturally sweet. Staff were surprised that many children had never tasted mango or guava, although Christchurch is a fairly well-to-do area.
In subsequent sessions, Janet presented the Ditch the Fizz rap, and encouraged pupils to compose their own song with a healthy message. Schools had the chance to perform their songs to each other. They also produced collages about healthy eating, which were eventually displayed in the foyer of the diabetes unit at the Royal Bournemouth Hospital. Pupils were encouraged to visit the Ditch the Fizz website and e-mail Janet with any questions about diet. Finally, there was a quiz in the style of Who Wants to be a Millionaire? to see how much they had remembered about healthy diets.
"Health education has got to be dynamic and fun - just like the advertising agency material we are trying to combat," says Janet. "I found this project the most fun thing I've done in my career; the children were so receptive and so rewarding.'
But have the effects worn off? Anne Bassett, whose 11-year-old daughter took part in the project 18 months ago, believes that Hannah is still very knowledgeable about healthy eating. "She is very fruit and veg-conscious and has banned chocolatey things from her lunch box," says Anne.
Ceri says she has become much more forceful in encouraging children and parents to pack healthy lunch boxes. The school has also sent out letters to parents advising fruit as a mid-morning snack rather than crisps or chocolate.
Mark Loveys, the Priory School's head teacher, says the project has made staff more aware of the importance of diet.
"We are under tremendous pressure from large food companies to promote their products, in exchange for 'free' equipment," he says. "We are now questioning their motives and asking how altruistic their gestures really are."
What of the future? Janet is now seeking funding to extend the Ditch the Fizz project to other Dorset schools, while Ceri would like to see regular links with health professionals and schools: "It would help us to keep up-to-date with all kinds of health issues; we are very keen to act on the information when we get it."
* "Preventing childhood obesity by reducing consumption of carbonated drinks: cluster randomised controlled trial", Janet James, Peter Thomas, David Cavan and David Kerr. British Medical Journal, May 2004, www.bmj.com
IT'S A RAP
DITCH THE FIZZ RAP
by Priory School
Drink plenty of water every day
Eat less sugar, fight tooth decay
Ease up on those fizzy drinks
Stop, take a minute and THINK!
Ditch the chips and eat them in their jackets
Try not to eat processed food in packets,
Five pieces of fruit and veg a day
Will help you go the right way.