Energy and macronutrients intake of children attending kindergartens in Kosovo (full day program-8 hours)

Main Article Content

Agim Rysha
Tahire M Gjergji
Angelika Ploeger

Keywords

Keywords: Energy intake, macronutrients, dietary assessment, child nutrition, nutrient intake

Abstract

Abstract:


Aim: Understanding preschool children’s food consumption in kindergartens may be one possibility to find out whether preschool children’s energy is adequate. The aim of the study was to evaluate the energy and macronutrient intake by children in kindergartens in Kosovo.


Methods: Preschool children (n = 469) aged 1<7 participated in three days’ dietary intake assessment through food measuring in kindergartens. The software Prodi was used to convert food items to constituent nutrients. The Anderson-Darling test was used to test if the dataset comes from a normal distribution. In contrast, Fisher’s and unpaired Student’s t-tests were used to see that data follow a normal probability distribution, the variances of the populations are equal, and the samples are independent. Analysis of Variance (ANOVA) was used to test the differences between means of energy and macronutrients among treatments (kindergartens).


Results: The children obtained more than 50% of their daily energy requirements. The energy intake across the five kindergartens showed significant differences (between 292±31.7 kcal and 1126± 201 kcal). Apart from differences in the energy level, an imbalanced share of energy was observed from each macronutrient. Overall, children in our study met the recommended daily carbohydrate intake already during their 8 hours stay in kindergarten.  The average protein intake by 1<4 old boys and girls exceeded the daily reference values for protein intake. The mean percentage of energy intake from fat was around 27 % of daily reference values.


Conclusions: The energy intake across the five kindergartens showed significant differences and it was observed that there was an imbalanced share of energy from each macronutrient. There is a need for the development of uniform dietary legal standards of nutrition in kindergartens in Kosovo.

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References

1. Kosovo Agency of Statistics – Education Statistics 2010-2011, retrieved from http://www.erisee.org/downloads/2013/2/Education%20Statistics%20%202010-2011%20ENG.pdf
2. Mendez R, Grissom M. Disorders of childhood growth and development childhood obesity. FP Essent 2013; 410: 20–24.
3. Kuhl ES, Clifford LM, Stark LJ. Obesity in preschoolers: behavioral correlates and directions for treatment. Obesity 2012;20 (1): 23-29.
4. Larson N, Ward DS, Neelon SB, Story M.What role can child-care settings play in obesity prevention? A review of the evidence and call for research efforts. J Am Diet Assoc2011; 111 (9): 1343-62.
5. Mikkelsen BE. Policies to promote on physical activity and healthy eating kindergartens from theory to practice. Int J Pediatr Obes 2011; suppl. 2: 8-11.
6. Leahy KE, Birch LL, Fisher JO, Rolls BJ. Reductions in entree energy density increase
7. Huybrechts I, Matthys C, Vereecken C, Maes L, Temme EHM, Van Oyen H, De Backer G, De Henauw S. Food Intakes by Preschool Children in Flanders Compared with Dietary Guidelines. Int J Environ Res Public Health 2008; 5 (4): 243-257.
8. Huynh DTT, Dibley MJ, Sibbritt DW, Tran HTM. Energy and macronutrient intakes in preschool children in urban areas of Ho Chi Minh City, Vietnam. BMC Pediatrics 2008; 8:44
9. Kyttälä P, Erkkola M, Kronberg-Kippilä C, Tapanainen H, Veijola R, Simell O, Knip M, Virtanen SM. Food consumption and nutrient intake in Finnish 1-6-year-old children. Public Health Nutr 2010; 13(6A):947-56
10. Lehtisalo J, Erkkola M, Tapananinen H, Kronberg-Kippilä C, Veijola R, Knip M, Virtanen SM. Food consumption and nutrient intake in day care and at home in 3-year-old Finnish children. Public Health Nutr 2010; 13 (6A): 957-64
11. Zhou SJ, Gibson RA, Makrides M. Nutrient intakes and status of preschool children in Adelaide, South Australia. MJA –Medical Journal of Australia 2012; 196: 696-700.
12. Vernarelli JA, Mitchell DC, Hartman TJ, Rolls BJ. Dietary Energy Density Is Associated with Body Weight Status and Vegetable Intake in US Children. J. Nutr. 2011; 141: 2204–2210.
13. Hebestreit A, Bornhorst C, Pala V, Barba G, Eiben G, Veidebaum T, Hadjigergiou C, Molnár D, Claessens M, Fernández-Alvira JM, et al. Dietary energy density in young children across Europe. Int. J. Obes. (Lond.) 2014; 38 (Suppl. 2): S124–S134.
14. Markovic TP & Natoli SJ (2009) Paradoxical nutritional deficiency in overweight and obesity: the importance of nutrient density. Med J Aust 190, 149–151.
15. Briley M, McAllaster M. Nutrition and the child‐care setting. J Am Diet Assoc. 2011; 111(9): 1298– 300.
16. American Dietetic Association. Position of the American Dietetic Association: Benchmarks for nutrition programs in child care settings. J Am Diet Assoc 2005; 105 (6): 979–986
17. Regulation on health protection requirements and nutrition in catering facilities in pre- school institutions and schools. Ministry of Social Affairs 2002; Estonia, 93: 27.06.2002. RTL 30.07.2002; 83: 1298. (In Estonian)
18. Rysha A, Gjergji TM, Ploeger A. Nutritional status of preschool children attending kindergartens in Kosovo Journal of Health, Population and Nutrition (2017) 36:26 DOI 10.1186/s41043- 017-0105-1
19. Rysha A, Gjergji TM, Ploeger A. Micronutrient intake by preschool aged children attending kindergartens in Kosovo, Progress in Nutrition 2019; Vol. 21, N. 3: 00-00 DOI: 10.23751/pn.v21i3.7335
20. Rysha A, Gjergji TM, Ploeger A. Dietary habits and food intake frequency of preschool children. Nutrition & Food Science 2017; 47 (4): 534-542.
21. Deutsche Gesellschaft für Ernährung, Österreichische Gesellschaft für Ernährung, Schweizerische Gesellschaft für Ernährung (eds): Referenzwerte für die Nährstoffzufuhr, ed 2. Bonn, 2015.
22. De Keyzer W, Lin Y, Vereecken C, Maes L, Van Oyene H, Vanhauwaert E, De Backer G, De Henauw S, Huybrechts I. Dietary sources of energy and macronutrient intakes among Flemish preschoolers. Archives of Public Health2011; 69: 1-5.
23. Reedy J, Krebs-Smith SM.Dietary sources of energy, solid fats, and added sugars among children and adolescents in the United States. J Am Diet Assoc 2010; 110: 1477-84.
24. Turner-McGrievy, G.M.; Hales, S.B.; Baum, A.C. Transitioning to new child-care nutrition policies: Nutrient content of preschool menus differs by presence of vegetarian main entrée. J. Acad. Nutr. Diet. 2014, 114, 117–123. [CrossRef] [PubMed]
25. Benjamin Neelon, S.E.; Reyes-Morales, H.; Haines, J.; Gillman, M.W.; Taveras, E.M. Nutritional quality of foods and beverages on child-care centre menus in Mexico. Public Health Nutr. 2013, 16. [CrossRef] [PubMed]
26. World Health Organization. Report of the Commission on Ending Childhood Obesity. World Health Organization; Geneva, Switzerland: 2016
27. Tovar, A.; Benjamin-Neelon, S.E.; Vaughn, A.E.; Tsai, M.; Burney, R.; Østbye, T.; Ward, D.S. Nutritional Quality of Meals and Snacks Served and Consumed in Family Child Care. J. Acad. Nutr. Diet. 2018, 118, 2280–2286.
28. Monsivais, P.; Johnson, D.B. Improving nutrition in home child care: Are food costs a barrier? Public Health Nutr. 2012, 15, 370–376.
29. Erinosho, T.; Dixon, L.B.; Young, C.; Brotman, L.M.; Hayman, L.L. Nutrition Practices and Children’s Dietary Intakes at 40 Child-Care Centers in New York City. J. Am. Diet. Assoc. 2011, 111, 1391–1397.
30. Padget A, Briley ME. Dietary intakes of child-care centers in central Texas fail to meet food guide pyramid recommendations. J Am Diet Assoc. 2005; 105(5):790–793. [PubMed: 15883557]
31. Mier N, Piziak V, Kjar D, et al. Nutrition provided to Mexican-American preschool children on the Texas-Mexico border. J Am Diet Assoc. 2007; 107(2):311–315. [PubMed: 17258969]
32. Davison KK, Jurkowski JM, Li K, Kranz S, Lawson HA. A childhood obesity intervention developed by families for families: results from a pilot study. Int J Behav Nutr Phys Act. 2013;10:3. [PubMed: 23289970]
33. Shannon M. Robson, Jane C. Khoury, Heidi J. Kalkwarf and Kristen Copeland. Dietary Intake of Children Attending Full-time Child Care: What are they eating away from the Child-Care Center? J Acad Nutr Diet. 2015; 115(9): 1472–1478.
34. Sigman-Grant M, Morita J. Defining and interpreting intakes of sugars. Am J Clin Nutr. 2003;78:815S–826S
35. Tucker LA, Seljaas GT, Hager RL. Body fat percentage of children varies according to their diet composition. J Am Diet Assoc 1997;97:981–6
36. Gazzaniga JM, Burns TL. Relationship between diet composition and body fatness, with adjustment for resting energy expenditure and physical activity, in preadolescent children. Am J Clin Nutr 1993;58:21–8
37. World Health Organisation . The World Oral Health Report. World Health Organisation: Geneva; 2003
38. Verduci E, Radaelli G, Stival G, Salvioni M, Giovannini M, Scaglioni S: Dietary Macronutrient Intake During the First 10 Years of Life in a Cohort of Italian Children. J Ped Gastr Nutr. 2007, 45: 90-95. 10.1097/MPG.0b013e318058ca4e
39. Huybrechts I, De Henauw S: Energy and nutrient intakes by pre-school children in Flanders-Belgium. Br J Nutr. 2007, 98: 600-610. 10.1017/S000711450773458X.
40. Foreyt JP, Salas-Salvado J, Caballero B, Bullo M, Gifford KD, Bautista I, Serra-Majem L. Weight-reducing diets: are there any differences? Nutr Rev 2009; 67 (Suppl 1): S99-101.
41. Gately PJ, King NA, Greatwood HC, Humphrey LC, Radley D, Cooke CB and Hill AJ (2007) Does a high-protein diet improve weight loss in overweight and obese children? Obesity 2007; 15: 1527-1534.
42. Braun KV, Erler NS, Kiefte-de Jong JC, Jaddoe VW, van den Hooven EH, Franco OH, Voortman T. Dietary Intake of Protein in Early Childhood Is Associated with Growth Trajectories between 1 and 9 Years of Age. J Nutr. 2016 Nov;146(11):2361-2367. doi: 10.3945/jn.116.237164. Epub 2016 Oct 12. PMID: 27733529
43. Sioen I, van Lieshout L, Eilander A, Fleith M, Lohner S, Szommer A, Petisca C, Eussen S, Forsyth S, Calder PC, Campoy C, Mensink RP. Systematic review on n-3 and n-6 polyunsaturated fatty acid Intake in European countries in light of the current recommendations - Focus on specific population groups. Ann Nutr Metab. 2017;70:39–50. [PMC free article] [PubMed] [Google Scholar]
44. Te Morenga L, Montez JM. Health effects of saturated and trans-fatty acid intake in children and adolescents: Systematic review and meta-analysis. PLoS One. 2017;12:e0186672. [PMC free article] [PubMed] [Google Scholar
45. Calder PC. Functional roles of fatty acids and their effects on human health. JPEN J Parenter Enteral Nutr. 2015;39:18S–32S. [PubMed] [Google Scholar]
46. Goldbohm RA, Rubingh CM, Lanting CI, Joosten KF. Food consumption and nutrient intake by children aged 10 to 48 months attending day care in the Netherlands. Nutrients. 2016;8:E428. [PMC free article] [PubMed] [Google Scholar]
47. Huysentruyt K, Laire D, Van Avondt T, De Schepper J, Vandenplas Y. Energy and macronutrient intakes and adherence to dietary guidelines of infants and toddlers in Belgium. Eur J Nutr. 2016;55:1595–1604. [PubMed] [Google Scholar]
48. Manios Y, Grammatikaki E, Papoutsou S, Liarigkovinos T, Kondaki K, Moschonis G. Nutrient intakes of toddlers and preschoolers in Greece: the GENESIS study. J Am Diet Assoc. 2008;108:357–361. [PubMed] [Google Scholar]
49. Butte NF, Fox MK, Briefel RR, Siega-Riz AM, Dwyer JT, Deming DM, Reidy KC. Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes. J Am Diet Assoc. 2010;110:S27–S37. [PubMed] [Google Scholar]

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