Introduction
María Ana Angeleri is changing the landscape of nutrition education through a creative health and wellness program that integrates parents, children, adolescents, teachers, and schools. Through a dynamic and interactive prevention program that focuses on healthy eating habits and self-initiative to make good food choices, María Ana is prioritizing nutrition inside and outside of the classroom.
The New Idea
María Ana is tackling the epidemic of childhood obesity and other non-communicable diseases by focusing on health and wellness rather than on obesity because she knows that diets for overweight and obese kids do not work. She is creating healthy nutrition habits from early childhood, and considers education to be the key driver needed to encourage nutritious food choices by the individual, family, and school. Because healthy habits can be built into school curricula and learned early on, María Ana sees school as the best forum for realizing her vision to promote a healthy lifestyle, body, and mind. Once schools create this enabling environment for engaged learning about nutrition and parents and students develop the tools to carry these lessons into the home, nutrition can be positioned as a priority and this framework for education will spread nationwide.
María Ana has shown that children of all income classes prefer and consume low nutritional quality diets and firmly believes that good nutrition is a product of the education of a family or child, not their economic status alone. Through innovative nutrition education programs, fun participatory games and learning, and access to quality web-based information that is accessible at home, María Ana is ensuring the children are active participants in curriculum development and have the motivation to care about their food choices. She is building an improved and scalable school infrastructure around health education.
The Problem
The World Health Organization (WHO) considers obesity an epidemic disease that has significant social, economic, and health-related repercussions in society. There are approximately 1.6 billion adults over fifteen years of age who are overweight. Costa Rica, Chile, Cuba, Uruguay, and Argentina are countries considered to be going through a post-nutrition transition, with diets rich in sugar and fat, and low in fiber, that have resulted in prevalent obesity and hyperlipidemia. Argentina, in particular, has the highest childhood obesity rates in children under five years in Latin America, at 7.3 percent.
Health subjects, particularly relating to nutrition, are not systematically incorporated into formal education in Argentina. When health topics are taught, teachers often use a top-down approach in the classroom, which limits the student’s capacity to contribute. Because the education system does not prioritize nutrition education, the health statuses and eating habits of the population are compromised, leading to population weight gain, obesity, and a rapidly spreading prevalence of micronutrient malnutrition.
In recent decades, the economic, social, and demographic transformations experienced by most Latin American countries has been accompanied by a process defined as the “nutrition transition.” The nutrition transition has resulted in a reduction in severe acute malnutrition, although it has led to a higher prevalence of stunted growth, obesity, and micronutrient malnutrition. Despite its prevalence, micronutrient malnutrition is difficult to measure, which is why it is often referred to as the “hidden undernourishment.” Micronutrient malnutrition is the result of a poor quality diet, not simply insufficient food quantity. In fact, many overweight or obese individuals experience deficiencies in essential vitamins and minerals, even though they may not be aware. As a result of the rise in obesity, many turn to dieting as a strategy, although dieting is not effective in the long-term; it is not a holistic solution. Tackling obesity and micronutrient malnutrition requires a behavioral, preventative, and education-focused solution, which it currently lacks.
The lack of prioritization of nutrition in many Latin American communities is reinforced by the invisibility of micronutrient malnutrition, which can occur without physical manifestation on the body. Despite the rise in micronutrient malnutrition, the lifestyle in Latin America is becoming more sedentary, the traditional cooking habits are adapting to global trends, and technological advancements encourage instant gratification. The result of this combination is the lack of social recognition and commitment to targeting and prioritizing nutrition. In order to improve population health and well-being, nutrition must be repositioned as a priority in people’s minds, homes, businesses, and schools.
The Strategy
María Ana sees nutrition education of children, parents, and schools as the most productive way to create healthy eating habits from early childhood.
One of the three key ingredients to her strategy is the creation of a close working relationship with schools to work not just on educating children, parents, and school leaders, but to also build step by step bridges between knowing about good nutrition and having healthy nutritional habits on a daily basis.
Second, María Ana uses the highest quality processes in every analysis, study and class, and in 2008 her organization was the first citizen organization (CO) of its kind in the country to win the internationally prestigious ISO9001 award. This certification has opened doors to key strategic partnerships with corporations that share her mission of creating healthy nutritional habits but also have more confidence in her work, knowing they have built in the highest quality.
To spread this vision, María Ana began bringing nutrition education into classrooms in 2004. She first incubated her idea in her own children’s schools. In 2007 she founded Fundación Educacional (Educational Foundation) with the aim to expand this model to schools nationwide. María Ana considers schools the ideal forum for the implementation and development of her idea. She first increases the visibility and prioritization of her work in schools by building relationships with school leadership. This partnership supports the implementation and growth of her educational program.
To prioritize her vision and make visible her strategy, María Ana and her team conduct diagnostic and awareness-building meetings with school principals and supervisors. During these discussions, María Ana and school leadership share the realities of malnutrition and obesity in schools and determine the top nutritional education goals. During these diagnostic visits, Educational Foundation (EF) conducts and presents a comprehensive field assessment to the directors and supervisors on the state of eating behaviors, motivations, and food preferences in their schools. Based on these findings, they draft individual proposals for the improvement of health education. In many cases, these proposals also address the handling and food storage within school cafeterias, as well as recommendations for nutritional food purchases that fits within the school budget.
Once EF builds this relationship with schools, they begin implementing the program using dynamic educational activities with parents and students. Parents are a key contributor because they ensure that the lessons carry into the home. These activities involve teamwork, participatory games, role playing, research, and group projects organized by the children and young people. For example, adolescents designed a school publication about nutrition and health with images and content that they developed. They shared these magazines among their classmates and now all classrooms and fairs have access to them. In addition, EF has devised dynamic nutritional teaching aids with the help of the students. These tools ensure the long-term implementation of the curriculum and its impact beyond EF’s classroom presence.
The next step in the school portion of her strategy is to become involved in offering more nutritious school lunch programs. This is a wonderful opportunity to bring to life her nutritious eating ideas and again involve students, parents, and school leaders. While there are political obstacles to overcome because food services are subcontracted to outsiders with influence from the Ministry of Education, María Ana tries to deliver messages about nutritious, tasty and inexpensive lunch ideas for the school system.
To have a long-lasting impact on the lifestyle of children and their families, EF has designed resources whose reach extends beyond the classroom. The first component of this strategy includes EF’s interactive website, which provides tools specifically for educators (parents and teachers). The second element empowers children to take nutrition education into their own hands. The “Children’s Club” feature of the website presents complementary information, interactive games and fun activities that reinforce knowledge acquired in the classroom. In addition, EF encourages physical activity and play by complementing in-classroom work with an outdoor recess curriculum. Students also gather traditional recipes and put them into a shared cookbook they can bring home to their families. This instills the importance of communal eating and other family traditions relating to food.
María Ana brings the highest quality standards to everything she does, a heritage from her previous career as an entrepreneurial researcher working in laboratories in the most exacting circumstances. When EF received ISO9001 certification, the award increased her credibility and effectiveness with corporations who want to be associated with the mission of creating healthier nutrition habits. Surprisingly, Coca Cola became her first major corporate sponsor, as EF became their corporate social responsibility effort, which led to joint projects in physical education, games, and nutrition classes.
EF’s certification has also helped to open doors with long-term partners, companies and authorities, including Fundación Acindar and Pan American Energy. EF has already delivered nutritional education trainings to two companies: La Mucca SA in Uruguay and Grupo Cliba in Argentina. They offer trainings for spouses of employees and staff who are mothers. María Ana plans to apply these strategies to other companies, in particular food companies, so that this type of education can be institutionalized.
EF has 380 partner schools across seven provinces in Argentina. It has reached over 64,845 children and begun a major train the trainer program for nutrition educators to spread the program throughout Argentina. EF is now partnering with other social organizations, such as Junior Achievement (who work within schools as well) and Banco de Alimentos (Food Banks), which focus on community dinners. María Ana is working to integrate her methodology into existing programs so that her vision can spread more rapidly.
Through EF’s efforts, nutrition education has changed the way food is purchased, served, consumed, taught, and represented in national policy. For example, EF’s partner schools have more diversified food choices during recess and lunchtime, such as dairy and fruit. In addition, María Ana has proven that healthy food in schools is possible, even within the municipalities existing budget.
EF is also reaching out to leading universities and think tanks to involve them in this mission. EF has published two research papers: One related to nutritional habits of children and another on the effectiveness of EF’s interactive learning model. It will work with research institutions to carry out third-party studies to measure children’s understanding of healthy nutrition habits, then changed attitudes, and ultimately, to measure the portion of obese children compared to levels a few years ago.
The Person
María Ana is an intuitive, hardworking, and dynamic entrepreneur. Raised in an Italian family, she learned the value of cooking and food culture at a young age. For the first fifteen years of her life, María Ana and her family moved around the world since her father was a geologist and had many international assignments. This mobile childhood taught her to adapt easily to new contexts and lifestyles and opened her eyes to diverse cultures around the world.
At 25, María Ana graduated with a degree in biochemistry, specializing in the field of reproductive medicine, an unusual field at the time. This work allowed her to build close relationships with couples who were experiencing reproductive difficulties and also empowered her with a way to address the issues she cared about. After continuing her studies in the U.S., she contacted the head of the Department of Gynecology and Obstetrics of the Municipal Hospital in the CABA Fernandez, Dr. Mario Comparato. There she discovered an absence of reproductive health services and a huge number of patients suffering due to this void. The diagnosis and treatment of infertility problems are expensive and therefore inaccessible for much of the population. María Ana became moved to address this inequality, so she mobilized her network of contacts, raised funds, and lined up resources to equip the hospital with the services they needed, and then ran the lab for several years as a volunteer.
In 1998, after the complicated birth of her third daughter, María Ana decided to explore a new professional path. She began a career in nutrition for a new perspective within the health field—one that focuses more on prevention than the treatment of diseases. After four years of studying and training in nutrition, including post graduate work, she initiated a series of study groups on issues related to child nutrition, which later evolved into EF and its educational services. In this venture, María Ana realized how much of her medical background was spent learning how to treat disease, rather than focusing on the prevention of disease or the health and well-being of the population. She devotes all her energy to thinking about nutrition in innovative and accessible ways. María Ana sees nutrition as a bridge from the treatment-focused medical world to one that more widely and sustainably improves the health of populations.