School meals – What do parents think?

Dr.sc. Nina Petričević, dr.med.

Nastavni zavod za javno zdravstvo dr. Andrija Štampar

Zagreb

• 70% - children participating in school meals

• 20% - children have three meals in school

• The new meal standards – by Ministry of health in 2013

National Guidelines for School Meals in Elementary Schools/ Nacionalne smjernice za prehranu učenika u osnovnim školama

• Long process ➢2008. New nutrition standards for schools in Zagreb

➢2010. Action plan for prevention and treatment of obesity

➢2013. National guidelines for school meals in elementary schools by Ministry of health

• To promote healthy eating habits in children

• Prevention of overweight

Obesity in children

• Global problem

• Croatia: 1 in 3 kids are overweight

• One of the most important health problems in 21st century

• In the past 20 years: children are heavier (5 - 9kg)

• Obesity and poor nutrition big threat to physical and mental health of the kids

• Obese kids – obese adults

New nutrition standards

• Analysis of old school menus • Insufficient proportion of protein• Too much fat and carbohydrate • Insufficient intake of vitamin A, vitamin C, iron and calcium

• Raise nutritious quality of meals by new standards• Limit servings of packaged food, deserts and meat products • Increase fruit and vegetables • Increase whole grains• Decrease processed food, fast food, • Increase milk as a beverage, no sweetened beverages

Recommendations

• For calorie intake

Age Daily calorie intake (kcal)/day

male female

7- 10 1600 - 1800 1600 - 1800

11 - 13 2000 - 2200 1800 - 2000

14 - 15 2400 - 2600 2000 – 2200

16- 18 2600 - 2800 2000 - 2200

OBROKUDIO DNEVNIH

POTREBA (%)

PREPORUČENE VRSTE

NAMIRNICA ZA POJEDINE

OBROKE

Doručak/mliječni

obrok

20-35%

Mlijeko ili mliječni proizvodi, žitne pahuljice ili

kruh od cjelovitog zrna, orašasti plodovi i

sjemenke, sir, maslac, marmelada, med, mliječni

namazi, svježe pripremljeni namazi od ribe ili

povrća, mesne prerađevine (naresci), jaja,

sezonsko voće i povrće.

Ručak 30-35%

Juhe, kuhano povrće ili miješana variva od

povrća, krumpira, mahunarki i žitarica, složena

jela od mesa s povrćem, krumpirom i

proizvodima od žitarica, meso, perad, riba, jaja,

salate od svježeg povrća i voće.

Užina 10-15%

Mliječni napitci (jogurt i drugi fermentirani

mliječni proizvodi), mlijeko sa žitnim pahuljicama,

kruh od cjelovitog zrna, namaz, okruglice,

štrukle, pite, voće, prirodni voćni sok, slastice.

Školski jelovnik kcal

Doručak-

Mliječni obrok

Kukuruzne pahuljice

s mlijekom i medom,

grožđicama i

bademima

Voće/jabuka

411,1

60,0

471,1

Ručak Varivo od poriluka

Kosani odrezak

Kruh kukuruzni 2 šnite

157,2

323,0

176,0

656,2

Užina Štrukli sa sirom kuhani ili

zapečeni

376,2

Ukupno 1503,5

PREPORUKE

Četvrtak g kcal kJ Bj/g M/g Uh/g Ca/mg C vit/mg vlakna/g Fe/mg

kukuruzne pahuljice 30 110,4 461,7 2,58 0,48 25,53 0,9 0 3,3 0,18

mlijeko 300 171,6 718,8 9,9 8,4 14,1 360 0 0 0,21

med 15 48 200,85 0,06 0 12 7,5 0 0 3

grožđice 10 24,6 102,9 0,11 0 6,44 6,1 0 0,68 0,16

bademi 10 56,5 236,4 1,69 5,35 0,43 25 0 1,43 0,42

jabuka 150 60 250,5 0 0 17,85 15 15 3,45 0,3

UKUPNO 471,1 1971,15 14,34 14,23 76,35 414,5 15 8,86 4,27

Prosijek kroz dva tjedna kcal kJ Bj/g M/g Uh/g Ca/mg C vit/mgvlakna/g Fe/mg

513,75 2149,5 19,06 18,05 70,56 344,66 22,11 8,75 3,2

New School menus implementation

• As expected, not everybody liked the change

• Kids protested, drop-off

• Opposition among parents and school stuff

• Schools reported a lot of food waste

Advised:

• not all kids will come around right away

• be persistent

• work with teachers and parents

• educate

School food today

• 5 years later

• mostly does not meet the standards

• not enough fruit and vegetables

• too much processed food and pastry

• sugary drinks and food

Study design

• Aim: to investigate parents’ perceptions and opinions about school meals

• Conducted by school doctors (dr. Miletić Činić, dr. Petričević)

• 7 elementary schools in Zagreb (5th and 6th grade)

School menus

School menus

ŠKOLSKA KUHINJA: JELOVNIK

19.03.2018.-28.03.2018.

PONEDJELJAK

D: PIZZA, ČAJ, VOĆE

U: KAJZERICA, PAŠTETA, ČAJ, VOĆE

UTORAK

D: KRUH, SIR, ŠUNKA, SOK, VOĆE

U: MALI BUREK SA SIROM, MLIJEKO, VOĆE

SRIJEDA

D: GRIZ, BANANA

U: PUTER ŠTANGICA, VOĆNI JOGURT

ČETVRTAK

D: ŽEMLJA, HRENOVKA, SENF, SOK, VOĆE

U: KAJZERICA, MLIJEČNI NAMAZ, MLIJEKO, VOĆE

PETAK

D:KUKURUZNI KROASAN, KAKAO, VOĆE

U:PUDING ČOKOLADA, VOĆE

ŠKOLSKA KUHINJA ZADRŽAVA PRAVO IZMJENA JELOVNIKA SUKLADNO AKCIJAMA I IZMJENAMA CIJENA ODREĐENIH PROIZVODA.

Škola pridržava pravo izmjene jelovnika u slučaju poteškoća s nabavom i dostavom namirnica.

16.11.2018PETAK

MLIJEČNI OBROK Svježe mlijeko, croissant čoko-lješnjakRUČAK Zapečena tjestenina sa sirom i vrhnjem, kruhUŽINAPolubijeli kruh, maslac, sok

Participants

• 565 parents (81% mothers)

• 69% response rate (565/819)

• Mean age of parents

• 40,7 ± 5,68 years

• Mean age of children (51,6% F)

• 11,4 ± 0,68 years

School n (%)

1. S.Benceković 26 4.6%

2. Odra 49 8.7%

3. Savski Gaj 173 30.6%

4. Žitnjak 87 15.4%

5. A. Cesarec 32 5.7%

6. P. Preradivić 81 14.3%

7. V. Žganec 117 20.7%

Total 565 100%

Methods

• Anonymous parent/guardian questionnaire

• 4 Yes/No questions

• 15 questions on parents’ perception and opinions about school meals

• „How strongly do you agree or disagree with the following?”

• Coding 1-5, strongly agree – strongly disagree

Results / Students’ eating habits

• 73,6% have school meals

• 40,3% buys food around school

• 27% brings food from home

• 53,7% eats regularly before school

• Participation in school meal program• More boys than girls (78,8% vs 69,1%, p=0.009)• More fifth graders than sixth graders (82,6% vs 64,3%, p<0,001)• More those who don't eat before school (80% vs 68%, p<0,001)

Parent questionnaire data results

• My child likes the food offered at school

• 47,2 % YES

• 45,7% NO

Parent questionnaire data results

• School meals are healthy and good quality

• 33,8 % YES

• 45,5 % NO

Parent questionnaire data results

• Food at school is not tasty

• 29,8 % YES

• 45,2% NO

Parent questionnaire data results

• Portions are too small

• 54 % YES

• 24,6 % NO

Parent questionnaire data results

• There is not enough fruit in school meals

• 41,7 % YES

• 41,8 % NO

Parent questionnaire data results

• There is not enough vegetables in school meals

• 56,2 % YES

• 20,8 % NO

Parent questionnaire data results

• There is too much bread and pastry in school menus

• 58,6 % YES

• 24,1 % NO

Parent questionnaire data results

• There is too much fast food in school meals

• 35,9 % YES

• 40,9 % NO

Parent questionnaire data results

• School meals are much healthier today than before

• 26,2 % YES

• 45,4 % NO

Parent questionnaire data results

• Healthy school meals are important for child’s behavior and academics

• 75,5 % YES

• 11,2 % NO

Parent questionnaire data results

• Children do not have enough time to eat a school meal

• 64 % YES

• 25,5 % NO

Parent questionnaire data results

• School meals do not meet healthy nutrition standards

• 49,2 % YES

• 24,8 % NO

Parent questionnaire data results

• Big changes are needed in improving school meals

• 68,2 % YES

• 19,9 % NO

More critical of school foods

• parents of children who do not participate in school meals (all questions p<0.005)

• younger parents

Conclusions:

• Parents disagree and want changes

• Partner with parents

• Be protective of children's health

• Parents – key influence on a child’s eating behavior

• Schools – ideal place to promote healthy eating habits

Hvala na pažnji/Thank you