Kindergarten and Primary School Kindergarten and Primary School Nutrition Improvment ProgramNutrition Improvment Program

in Countyin County of Istria of Istria

Olga Dabović RacOlga Dabović Rac, MD, MD

Sunčica Matanić – StojanovićSunčica Matanić – Stojanović, sanitary engeener , sanitary engeener

Aleksandar StojanovićAleksandar Stojanović,, MD MD

ZAVOD ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJEZAVOD ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJEISTITUTO DI SANITÀ PUBBLICA DELLA REGIONE ISTRIANAISTITUTO DI SANITÀ PUBBLICA DELLA REGIONE ISTRIANA

INSTITUTINSTITUTEE OF PUBLIC HEALTH COUNTY OF ISTRIA OF PUBLIC HEALTH COUNTY OF ISTRIA

Forlimpopoli, June 27, 2014Forlimpopoli, June 27, 2014

Croatian Recommendations and Guidelines for CCroatian Recommendations and Guidelines for Children's hildren's HHealth ealth CCare, are, HHygiene and ygiene and PProper roper NNutrition of utrition of CChildren in hildren in KKindergartensindergartens

Children who are spending 7-8 hours in the kindergarten should consume 75% to 80% 75% to 80% of the daily energy and nutrient requirements while they are in kindergarten.

Energy and nutrient requierments can be achieved through 4 meals:

breakfast (25%breakfast (25%)) snack (10%)snack (10%) lunch (30%)lunch (30%) snack (10%)snack (10%)

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Kindergarten Nutrition Kindergarten Nutrition Improvement PImprovement Program in rogram in

CountyCounty of Istria of Istria

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UUnique program nique program in Croatia since 1980s

Calculations of the energy and nutrient content of kindergarten menus

Microbiological and sanitary supervision of kindergarten kitchens

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Old Laboratory Evidance and DocumentationOld Laboratory Evidance and Documentation

HistoryHistorywww.zzjziz.hr

Hygenic and Sanitary Control Report Hygenic and Sanitary Control Report 1983.1983. and 1984. and 1984. ((KKindergartenindergarten KamenjakKamenjak))

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Hygienic and Hygienic and SSanitary anitary CControl ontrol RReport, 1984eport, 1984..(Kindergarten (Kindergarten KamenjakKamenjak))

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Daily Daily CConsumption of onsumption of FFood, May 1993ood, May 1993.. ((Kindergarten Kindergarten CentCentaarr, , KKitchenitchen))

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Aim of the ProgramAim of the Program

To improve the quality of kindergarten foodquality of kindergarten food

To enhance the health education health education of children, their parents, kitchen staff and teachers

To promote healty eating patterns in childhood healty eating patterns in childhood and by doing so to promote optimal healthpromote optimal health and prevent some prevent some health problemshealth problems in later year

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Analysis of Food QualityAnalysis of Food Quality

Sampling and chemical analysis an all-day mealall-day meal (4 times a year)

Nutritional analysis of weekly menusweekly menus

Calculations are based on:Kaic Rak A. and Antonic K. Tables of the composition of foods and drinks, Institute of Public Health Croatian, Zagreb , 1990).

Recommended values (German Nutrition Society (DGE), Austrian Nutrition Society (OGE), Swiss Society for Nutrition Research (SGE), Swiss Nutrition Association (SVE) Reference values for nutrient intake. 1st edition in German-Frankfurt / main: Umschau / Braus, 2000. 57-125 specified in the amendment Program children's health care, hygiene and proper nutrition in kindergarten)

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Microbiological and Sanitary Supervision of Microbiological and Sanitary Supervision of Kindergarden kitchen Kindergarden kitchen

KKitchenitchen, dining roomdining room, , utility room utility room review with epidemiological survey epidemiological survey (4 times a year)

Kitchen, utility room, dinning room reviewEnviromental sampling – food premisis swabbing

SSwabwabinging in the kitchen and on the premises for food distribution and dining (usually 10 swabs10 swabs); in regional kindergarten 5 swabs

After each visit the results of all analysis are submitted to kindergarten in a reportreport.

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ReportsReports

In report there are comments on the results of chemical and calculated nutritional analysis of daily meals intake, their energy and nutritional value and content of nutrients:

In report we p point oint to possible failures failures and deficit deficit and make recommendationsrecommendations for their eliminationelimination and culinary tipsculinary tips for improvementimprovement.

Microbiological test procedures for the examination of food and beverages have been standadized and regulated, but nearly every country has its own regulation

and the relationship between the three major nutrients (protein, fat and carbohydrates).

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Example of reportExample of reportwww.zzjziz.hr

Advices for healthy eating in kindergartenAdvices for healthy eating in kindergarten

Seasonal menu suggestions

Examples of menus are always in line with the Mediterranean diet Mediterranean diet and traditional Istrian diettraditional Istrian diet.

Every menue contains folowing food:fishvarious meatseasonal fruit, vegetables and legumescerealswhole grainsherbs

We suggest not to use not to use food such as: salami, industrial spices, meat products, and semi-prepared meals.

Our suggestion is to boilboil and stewstew food instead of deep fat frying

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Istria County SituationIstria County Situation

37 central kindergartens 37 central kindergartens prepare the food and in 55 regional 55 regional and 32 32 private kindergartensprivate kindergartens the food is catered from central kindergartens

All kindergartens are subject of hygienichygienic and epidemiological epidemiological survillancesurvillance

Financial supportFinancial support for program give local communities, citieslocal communities, cities and municipalitiesmunicipalities.

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Nutrition improvment programNutrition improvment program

TTeaeam workm work

Epidemiologists, sanitary engineers, food technology engineers, biologist, chemical technicians

In kindergarten: cooperation with kindergarten staff - teachers, nurses, kitchen staff kindergarten, parents, suppliers, manufacturers

LLocal communityocal community support support

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Primary School Nutrition Primary School Nutrition Improvement Program in County Improvement Program in County

of Istriaof Istria

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In order to improve nutrition improve nutrition in primary schools we proposproposeded optimal menu optimal menuss.

Barriers in program implementation are:lack of kitchen stafflack of kitchen stafflack of education lack of education for kitchen staffthe primary role the primary role of schools in educationeducation and notnot in the preparation of mealspreparation of mealslimited financial resourceslimited financial resourceslack of motivation lack of motivation of parents and school staff.

Each school in Pula applied HACCP(Hazard analysis and critical control points)

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Program Program AActivitiesctivities

In each school we educate staff educate staff (kitchen staff, teachers, pedagogues, psychologists, directors).

In each school we educate children educate children about proper nutrition (5th and 6th graders) and give them the flyersflyers about healthy about healthy eatingeating.

Teachers in parentparent - teacher - teacher meetingsmeetings talk about healthy eating activities in school.

Improving school menusmproving school menus (work in progress)

Menu adaptation enu adaptation according to kitchen possibilitieskitchen possibilities.

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PresentationPresentation of of SSchool chool MMenuenuss ( (SSeptember 2013.)eptember 2013.)

Institute of Public Health proposed optimal proposed optimal menumenus.s.

Chefs of all schools cookcookeded meals together meals together..

Children tasttasteded and evaluatevaluateded what they ate.

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