© Borgis - New Medicine 2/2014, s. 47-51
*Sylwia Merkiel, Wojciech Chalcarz
Challenges of dietary intake assessment in preschool children – conclusions from a dietary intervention study on polish preschoolers1
Food and Nutrition Department of the Eugeniusz Piasecki University School of Physical Education in Poznań, Poland
Head of the Department: prof. dr hab. Wojciech Chalcarz
Summary
Aim. The aim was to present difficulties connected with dietary intake assessment in preschoolers which we concluded from a dietary intervention study.
Results. The intervention study aimed to modify preschoolers’ dietary intake and physical activity to improve their nutritional status and physical fitness. We chose a seven-day weighed food record to ensure the highest validity of the results and to reduce the risk of casualness. One of the difficulties was the fact that the data had to be recorded by several people, including preschool staff and family members. The necessity to weigh and write down all foods consumed by the children was one of the most frequent complaint from parents and preschool staff and reason for withdrawing some children from the study. To calculate energy and nutrient intakes, we used Dieta which we think is the best such computer programme in Poland. However, it does not provide the possibility to add to its database new dishes, foodstuffs or supplements.
The effort of keeping the food record was the discouraging factor for many parents to take part in the study. Preschool staff were dissatisfied with many of the dietary changes. Most parents were highly dissatisfied with the effort to introduce dietary changes at home.
Summary. When selecting method of dietary intake, seven-day weighed food record should be preferred. The Dieta is a very useful tool for calculating dietary intakes, however it requires urgent improvements. Dietary intervention studies in preschoolers should last longer than a preschool year and should include extensive education of preschool staff and parents.
INTRODUCTION
Preschool children are one of the most important groups of people in the society. If the country and the society are able to provide adequate conditions for them to develop appropriately and to adopt a healthy lifestyle, they will form in the future a healthy society. One of the main features of a healthy society is low morbidity and mortality from diet-related diseases. But it is not only a matter of a healthy society but also of an affluent society since diet-related diseases pose a considerable economic burden. Reducing the prevalence of diet-related diseases by modifying dietary intake in the society, may bring substantial economic benefits (1).
The living conditions of people in the developed countries are very favourable for the development of diet-related diseases. These conditions include easy access to public transport, availability of cars, varied television programmes, computers in more and more households, the opportunity to communicate with other people without the necessity to move out of home due to the access to the Internet, all of which significantly reduce daily physical activity. This reduction in physical activity level may be observed among preschool children (2-6). But these conditions include also more and more processed foodstuffs, easy access to cheap energy-dense foods rich in saturated fatty acids and non-milk extrinsic sugars but poor in essential fatty acids or vitamins, as well as sweets and fast foods which are advertised heavily especially to young people. It is therefore not surprising that food habits of preschool children are not in line with current nutrition recommendations (7-9) and that nutritional knowledge of their parents is poor (10-14).
The effect of the abovementioned conditions is decreasing physical activity level in the societies of the developed countries along with poor nutritional values of the daily diets, both of which are causes of diet-related diseases. Inappropriate dietary intakes rank highest among the risk factors for death in Western Europe, while physical inactivity takes the fifth place (15). Therefore, prevention of diet-related diseases should focus on popularising a healthy lifestyle which includes not only physical activity but also – or rather first of all – a balanced diet. The easiest way to physically active society characterised by adequate energy and nutrient intakes is to raise children on a healthy diet and teach them healthy food habits and active ways of spending time (16-18).
Preschool children should be taught how to eat healthy not only because they should acquire healthy food habits for the whole life but also because diet-related diseases develop slowly for many years and may have their origin as early as in childhood. That is why dietary intake assessment in preschool children should be considered one of the most important tasks of any country which aims to have a healthy society. Knowledge on dietary intakes of preschoolers is indispensable to work out and implement nutrition intervention programmes to teach them and their parents how to eat healthy.
However, the information about dietary intakes in Polish preschoolers is sparse. The most details on dietary intakes of children aged 4 to 6 years are included in a national study on a representative sample carried out by Szponar et al. (19). Two other studies provide information about intake of energy and selected nutrients in 4-6-year-olds from Szczecin (20) and Warsaw (21) and one study – about dietary intakes of 3-year-old children who attended preschools in Kraków (22). The results of these studies (19, 20, 22) showed many inadequacies in preschoolers’ diets. Other information about what preschool children eat are based on the assessment of preschool menus (23-35) which means only the assessment of the meals offered to children, not necessarily equivalent to what they really ate. In several studies, food habits of preschool children were assessed (7-9, 36-39) which is very important but gives no information about intake of energy and nutrients. However, no intervention studies on Polish preschool children have been published so far.
The reason for those few studies on dietary intake assessment in preschoolers may be many difficulties which the researcher has to face. However, if these difficulties are well-defined, the researcher may prepare adequately to such assessment and prevent them.
AIM
The aim of this study was to present difficulties connected with the dietary intake assessment in preschool children which are concluded from a dietary intervention study on Polish preschoolers.
METHODOLOGICAL OUTLINE OF THE DIETARY INTERVENTION STUDY ON POLISH PRESCHOOLERS
The aim of our intervention study was to modify preschoolers’ dietary intake and physical activity in order to improve their nutritional status and physical fitness which is of highest importance in the prevention of diet-related diseases. We assessed dietary intakes from a 7-day weighed food record and estimated physical activity by means of accelerometers, ActiGraph GT3X. Indices of nutritional status included anthropometric, biochemical and haematological indices. To obtain anthropometric indices, we measured body weight and body height, as well as body composition by bioelectrical impedance. Biochemical indices were serum glucose, protein, total cholesterol, HDL cholesterol, LDL cholesterol, triacylglycerols, iron, iron binding capacity, ferritin, transferrin, sodium, potassium, calcium, magnesium and phosphorus. Moreover, children’s blood pressure was taken. Physical fitness was assessed using physical fitness test for preschool children worked out by Sekita (40) which we used in our previous study (41). This test allows to determine the level of agility, power, strength and speed.
All these measurements were made at the beginning of the preschool year and were followed by modification of the preschool menus and education of the preschool staff and children’s parents. The education included nutritional and physical activity recommendations for the preschool children. At the end of the preschool year, all the abovementioned measurements were repeated.
SELECTING METHOD OF DIETARY INTAKE ASSESSMENT
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Piśmiennictwo
1. Selmer RM, Kristiansen IS, Haglerod A et al.: Cost and health consequences of reducing the population intake of salt. J Epidemiol Community Health 2000; 54(9): 697-702. 2. Chalcarz W, Merkiel S: Charakterystyka aktywności ruchowej nowosądeckich dzieci w wieku przedszkolnym, in Polish. (Physical activity in preschool children from Nowy Sącz and the vicinity.) Medycyna Sportowa (Polish J Sport Med) 2005; 21: 425-431. 3. Chalcarz W, Merkiel S, Pach D, Lasak Ż: Charakterystyka aktywności fizycznej poznańskich dzieci w wieku przedszkolnym, in Polish (Physical activity in preschool children from Poznań). Medycyna Sportowa (Polish J Sport Med) 2008; 24(5): 318-329. 4. Merkiel S, Chalcarz W, Deptuła M: Porównanie aktywności fizycznej oraz ulubionych form spędzania czasu wolnego dziewczynek i chłopców w wieku przedszkolnym z województwa mazowieckiego, in Polish. (Comparison of physical activity and favourite ways of spending free time in preschool girls and boys from the Mazowsze region.) Rocz Panstw Zakl Hig 2011; 62: 93-99. 5. Merkiel S, Chalcarz W, Roszak M: Analiza aktywności fizycznej dzieci w wieku przedszkolnym z Darłowa. Część I. Zwykła i dodatkowa aktywność fizyczna oraz ulubione formy spędzania czasu wolnego, in Polish. (Analysis of physical activity in preschool children from Darłowo. Part 1. Ordinary and additional physical activity and favourite ways of spending leisure time.) Medycyna Rodzinna 2014; 17(1): 3-11. 6. Chalcarz W, Merkiel S: Analysis of physical activity in preschool children from Piła. Part 1. Ordinary and additional physical activity and favourite ways of spending leisure time. New Med (Wars) 2014; 18(1): 3-11. 7. Chalcarz W, Merkiel S, Hodyr Z: Food behaviour in preschool children from Pabianice. New Med (Wars) 2009; 13(1): 7-12. 8. Gacek M: Sposób żywienia dzieci przedszkolnych ze środowiska wielkomiejskiego, in Polish. (Dietary patterns in nursery school children from an urban environment.) Rocz Panst Zakl Hig 2012; 63(4): 477-482. 9. Weker H, Rudzka-Kańtoch Z, Strucińska M et al.: Żywienie dzieci w wieku przedszkolnym. Ogólna charakterystyka sposobu żywienia, in Polish. (Nutrition of children at preschool age. General considerations and assessment of children nutrition.) Rocz Panstw Zakl Hig 2000; 51: 385-392. 10. Merkiel S, Chalcarz W: Wiedza żywieniowa rodziców dzieci przedszkolnych z Nowego Sącza i okolic. 1. Wiedza ogólna o żywieniu dzieci, in Polish. (Nutritional knowledge of parents of preschool children from Nowy Sącz and the vicinity. 1. General principles of nutrition during childhood.) Żyw Człow Metab 2009; 36(2): 385-389. 11. Chalcarz W, Merkiel S: Wiedza żywieniowa rodziców dzieci przedszkolnych z Nowego Sącza i okolic. 2. Żywienie w profilaktyce chorób dietozależnych, in Polish. (Nutritional knowledge of parents of preschool children from Nowy Sącz and the vicinity. 2. Nutritional prevention of diet-related diseases.) Żyw Człow Metab 2009; 36(2): 390-395. 12. Merkiel S, Chalcarz W: Wiedza żywieniowa rodziców dzieci przedszkolnych z Nowego Sącza i okolic. Część 3. Bogate źródła składników mineralnych i witamin, in Polish. (Nutritional knowledge of parents of preschool children from Nowy Sącz and the vicinity. 3. Rich sources of minerals and vitamins.) Nowa Pediatria 2010; 14(1): 15-20. 13. Merkiel S, Chalcarz W: Wiedza żywieniowa rodziców dzieci przedszkolnych z Nowego Sącza i okolic. 4. Rola składników pokarmowych i bilansowanie diety, in Polish. (Nutritional knowledge of parents of preschool children from Nowy Sącz and the vicinity. 4. The role of nutrients and principles of composing a diet.) Rocz Panstw Zakl Hig 2010; 61(4): 379-383. 14. Chalcarz W, Merkiel S: Wiedza żywieniowa rodziców dzieci przedszkolnych z Nowego Sącza i okolic. 5. Technologia przygotowania potraw, in Polish. (Nutritional knowledge of parents of preschool children from Nowy Sącz and the vicinity 5. Preparing meals.) Rocz Panstw Zakl Hig 2010; 61(4): 385-388. 15. Institute for Health Metrics and Evaluation: http://vizhub.healthdata.org/irank/arrow.php. 16. Chalcarz W: Koncepcja nauczania zasad żywienia w profilaktyce chorób cywilizacyjnych, in Polish. (The idea of teaching the principles of nutrition in diet-related diseases prevention.) Nowa Szkoła 1991; 47: 330-332. 17. Chalcarz W, Romańska I, Ziętkiewicz E: Konieczność uwzględnienia zasad żywienia w profilaktyce chorób cywilizacyjnych w nauczaniu początkowym, in Polish. (The necessity of implementing the nutritional guidelines for diet-related diseases prevention in elementary school curricula.) Nauczanie Początkowe 1991/1992; 15(1): 47-50. 18. Ożdziński J, Chalcarz W: Zdrowie przez wychowanie fizyczne i sport, in Polish. (Health through physical education and sport.) Wych Fiz Zdrow 1994; 4: 193-197. 19. Szponar L, Sekuła W, Rychlik E et al.: Badania indywidualnego spożycia żywności i stanu odżywienia w gospodarstwach domowych, in Polish. (Research on individual food intake and nutritional status in households.) Instytut Żywności i Żywienia, Warszawa, 2003. 20. Sadowska J, Krzymuska A: Ocena in Polish. uzupełniania przedszkolnej racji pokarmowej przez rodziców u dzieci w wieku przedszkolnym, (The estimation of complementation of the nursery school food rations by parents of pre-school children.) Bromat Chem Toksykol 2010; 43(2): 203-211. 21. Starbała A, Bawa S, Wojciechowska M, Weker H: Wartość energetyczna diety oraz spożycie makroskładników pokarmowych przez otyłe i normosteniczne dzieci uczęszczające do przedszkola, in Polish. (Energy value of daily diets and macronutrients consumption of obesity and normal weight children at pre-school age.) Bromat Chem Toksykol 2009; 42(3): 747-753. 22. Sochacka-Tatara E, Jacek R, Sowa A, Musiał A: Ocena sposobu żywienia dzieci w wieku przedszkolnym, in Polish. (Assessment of preschool children’s diet.) Probl Hig Epidemiol 2008; 89: 389-394. 23. Szponar L, Dyczkowska U, Mieleszko T: Jakość żywienia w przedszkolach, in Polish. (The quality of the diet in preschools). Pediatr Pol 1990; 66(3/4): 51-58. 24. Klemarczyk W, Strucińska M, Weker H, Więch M: Ocena sposobu żywienia dzieci w przedszkolu wegetariańskim, in Polish. (Assessment of preschool vegetarian menus). Pediatr Współcz 2005; 7 (3): 243-246. 25. Kozioł-Kozakowska A, Schlegel-Zawadzka M: Jakościowa ocena jadłospisów przedszkolnych w regionie Krakowa, in Polish. (Qualitative assessment of preschool menus in Kraków). Żyw Człow 2007; 34 (1/2): 133-138. 26. Czech A, Kęska A: Zawartość składników pokarmowych w racjach przedszkolnych w okresie wiosennym i jesiennym, in Polish. (Nutrient content in preschool food rations in spring and autumn.) Żyw Człow 2007; 34(1/2): 567-571. 27. Czech A, Kęska A: Zawartość składników pokarmowych w zimowych i letnich posiłkach przedszkolnych, in Polish. (Nutrient content in preschool food rations in winter and summer.) Żyw Człow 2007; 34(1/2): 572-577. 28. Merkiel S, Chalcarz W, Wegner M: Ocena jadłospisów przedszkolnych. Część I. Energia i makroskładniki, in Polish (Assessment of preschool menus. Part 1. Energy and macronutrients.) Medycyna Środowiskowa 2009; 12(1): 75-80. 29. Chalcarz W, Merkiel S, Wegner M: Ocena jadłospisów przedszkolnych. Część II. Witaminy i składniki mineralne, in Polish (Assessment of preschool menus. Part 2. Vitamins and minerals). Medycyna Środowiskowa 2009; 12(1): 81-84. 30. Kowieska A, Biel W, Chalaba A: Jakościowa ocena żywienia dzieci w wieku przedszkolnym na podstawie jadłospisów, in Polish (Assessment of children nutrition on the basis of preschool menus). Żyw Człow 2009; 36(1): 179-184. 31. Dymkowska-Malesa M, Skibniewska KA: Udział posiłków przedszkolnych w pokryciu zapotrzebowania na podstawowe składniki odżywcze i energię, in Polish (Meals served at nursery schools and their share in meeting the recommended daily demand for nutrients and energy.) Bromat Chem Toksykol 2011; 44(3): 374-379. 32. Frąckiewicz J, Ring-Andrzejczuk K, Gronowska-Senger A: Zawartość energii i wybranych składników w racjach pokarmowych przedszkoli z rejonu warszawskiego, in Polish (Energy and selected nutrients content in pre-school children diet of Warsowia district.) Rocz Panst Zakl Hig 2011; 62(2): 181-185. 33. Górnicka M, Frąckiewicz J, Trela I: Zawartość wybranych witamin w racjach pokarmowych przedszkoli na terenie Warszawy i okolic, in Polish (Selected vitamins content in pre-school children diet in Warsaw and regions.) Rocz Panst Zakl Hig 2011; 62(2): 205-208. 34. Barbarska O, Zegan M, Czerwonogrodzka-Senczyna A, Michota- in Polish Katulska E: Jakościowa i ilościowa ocena jadłospisów przedszkoli publicznych i prywatnych, (Qualitative and quantitative assessment of menus in public and private preschools). Żyw Człow 2012; 39(3): 176-190. 35. Dymkowska-Malesa M, Szparaga A: Ocena spożycia wybranych witamin i składników mineralnych w przedszkolnych racjach pokarmowych dzieci z terenu Koszalina, in Polish. (Evaluation of intake of selected vitamins and minerals in the diets of preschool children from Koszalin.) Nowa Pediatria 2013; 17(3): 106-110. 36. Kozioł-Kozakowska A, Piórecka B, Jagielski P, Schlegel-Zawadzka M: Suplementacja diety preparatami witaminowo-mineralnymi wśród dzieci w wieku przedszkolnym w Krakowie, in Polish. (Using vitamin and mineral supplements by preschool children in Kraków). Żyw Człow 2009; 36(1): 12-18. 37. Łoś-Rycharska E, Niecławska A: Analiza wybranych cech diety dzieci w wieku poniemowlęcym i przedszkolnym w zależności od sposobu sprawowania opieki nad dzieckiem, in Polish. (The analysis of chosen features of young children’s diet in dependence on socio-economic situation.) Pediatr Pol 2010; 85(5): 462-470. 38. Łoś-Rycharska E, Niecławska A: Analiza wybranych cech diety dzieci w wieku przedszkolnym i poniemowlęcym w zależności od sytuacji społeczno-ekonomicznej rodzin, in Polish. (The analysis of chosen children’s diet properties in 2–3 years old and preschool children in dependence on the type of care.) Pediatr Pol 2010; 85(5): 471-480. 39. Stankiewicz J, Lange M: Mleczne napoje fermentowane w żywieniu dzieci w wieku przedszkolnym, in Polish. (Fermented milk drinks in the diet of nursery age children.) Bromat Chem Toksykol 2012; 45(2): 191-195. 40. Sekita B: Rozwój somatyczny i sprawność fizyczna dzieci w wieku 3-7 lat, in Polish (Somatic development and physical fitness in 3-7-year old children), in: Rozwój sprawności i wydolności fizycznej dzieci i młodzieży, in Polish (Physical and aerobic fitness in children and youths) (Ed.: Pilicz S), Seria Z Warsztatów Badawczych, Wydawnictwo AWF, Warszawa 1988. 41. Merkiel S, Chalcarz W: The relationship between physical fitness, urine iodine status, and body-mass index in 6- to 7-year-old Polish children. Int J Sport Nutr Exerc Metab 2011; 21(4): 318-327. 42. Merkiel S, Chalcarz W: Nutrition in preschool age: Part 1. Importance, reference values, methods of research and their application. Review. New Med (Wars) 2007; 11(3): 68-73. 43. Serdula MK, Alexander MP, Scanlon KS, Bowman BA: What are preschool children eating? A review of dietary assessment. Annu Rev Nutr 2001; 21(1): 475-498. 44. Kunachowicz H, Nadolna I, Przygoda B, Iwanow K: Tabele składu i wartości odżywczej żywności, in Polish (Tables of food composition and nutritional value), Wydawnictwo Lekarskie PZWL, Warszawa 2005.
