*Szilvia Molnár1, Róbertnè Csajbók1, Magdolna Sinka2, Katalin Rozgonyi1, Leila Bándli2, Tímea Tóth1, Melinda Rados3, Ágnes Kemenczei4, Barbara Nagy5
Current challanges faced by public catering. Public catering as a tool for behavioural education with a potential to form healthier dietary attitudes
1Department of Dietetics and Nutrition Sciences, Institute of Applied Health Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
Head of Faculty: Professor Zoltán Zsolt Nagy, MD, PhD
2Department for Epidemiology, Institute for Health Promotion and Clinical Methodology, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
Head of Faculty: Professor Zoltán Zsolt Nagy, MD, PhD
3Department of Applied Psychology, Institute of Basic Health Sciences, Faculty of Health Sciences, Semmelweis University, Budapest, Hungary
Head of Faculty: Professor Zoltán Zsolt Nagy, MD, PhD
4Directorate for Food Safety and Risk Assessment, National Food Chain Safety Office, Budapest, Hungary
Director General: Sarolta Barna, MD
5National Institute of Pharmacy and Nutrition, Budapest, Hungary
Director General: Csilla Pozsgay, MD
Introduction. Public catering (also known as mass catering) is an area of nutrition of the population by which the frequency of nutrition-related diseases can be significantly mitigated with the introduction of effective preventive measures. This hypothesis is supported by several studies from all over the world. The analysis of these studies enables a more accurate view on the efficiency of regulative legal measures adopted with regard to public catering.
Aim. The aim of this study was to study legal regulations of different countries that are similar to Hungarian Ministerial Decree No. 37/2014 (IV.30) EMMI on the nutritional regulations of public catering, as well as to compare the results of our survey, conducted in order to assess the efficacy of the aforementioned Hungarian legal act, with data concerning nutrition of children from other countries, with the emphasis on Slovakia.
Material and methods. The study was conducted between November 2015 and March 2016. 173 Hungarian catering managers, as well as 53 Hungarian and 40 Slovak school children who regularly eat meals provided by public catering, participated in our study. All the participants were selected randomly. We processed and aggregated the data obtained and performed statistical tests, using Microsoft Excel and the R Project software. We compared the menus available in schools to the applicable legal regulations and analysed them, using the NutriCompÉtrend Sport 3.03 (Hungarian version of NutriComp Diet Sport 3.03) software.
Results. We discovered that the main factor which influenced the opinion of children on their meals was their taste, but external factors influencing their perception of the meal (such as the appearance of the meal, its taste, general cleanliness, being familiar with the food served, healthiness of the meal and presence of friends) were also important, which was independent from their country of origin. The participating Hungarian children more frequently than Slovak children described their meals as undersalted. Only a small percentage of the participants studied the menu attentively. Energy content and nutritive value of the meals offered by public catering services differed significantly and the analysed menus failed to meet the governmental recommendations accurately in both countries. Energy content and salt content were not consistent with the recommendations in both countries.
Even though the majority (87%) of the public catering service kitchens in Hungary introduced some required technical or technological alterations during the grace period allowed by the Decree No. 37/2014 EMMI, the majority of them (62%) still needed further alterations at the time of the study in order to fully comply with the Decree, as declared by managers of the catering services that participated in our study.
Conclusions. One of the most important problem at the time of the study was the need of modernization that should be pursued as soon as possible by the majority of the catering facilities. The taste of meals provided by mass catering is currently far from optimal and, therefore, development in formulation is needed, including introduction of new technologies and new raw materials. The analysis of our results proved that the demand for mass catering services depends on the quality of the food provided and on external factors influencing the perception of the meal, and that there is demand for the development of healthy meals. Complying with the operating law and satisfying the expectations of the consumers are not easy tasks and, therefore, cooperation between all the subjects that contribute to the public catering chain is important. Governmental support is also indispensable.
The frequency of nutrition-related diseases is growing not only in Hungary, but all over the world (1). Various measures have been taken globally in order to preserve health and decrease the frequency of these diseases. Similarly to other European countries, Hungary also strives to increase health consciousness of the citizens, and their activities also involve the promotion of healthy nutrition. The governments and health services are now aware that it is more effective to prevent the diseases, rather than to treat them to restore health (1-3).
Public catering is defined as an organized supply of food for groups of people of different gender, age or occupation. This includes, among others, food supply for children and youths (i.e. kindergartners, pupils, students, boarding school students and children in orphanages), for college and university students, employees, prisoners, homeless persons or people in financial need, patients and residents of social care institutions (4).
Public catering is expected to have a great role in improving public health. Firstly, it should satisfy the energy and nutritive requirements of consumers of different age, gender and physical activity level. Secondly, it should also encourage the consumers to direct themselves towards a more healthy diet. This is to be done by influencing their preferences through promoting the consumption of more nutritious foods and introduction of advanced food processing technologies. The offered meals should fulfil the expectations of consumers in terms of both quality and quantity to the biggest possible extent.
This can be achieved if public catering promotes healthy nutrition both in theory and in practice, making them gradually more accepted by the society. The responsibility of public caterers is the greater, the greater is their variety of consumers they serve and the bigger is the amount of meals served. It is of extreme importance to control what children in social care and educational institutions eat, since health consciousness, dieting behaviours, habits and taste preferences are still formed in these age groups, and habits adopted at an early age will have vast influence on their adult habits and preferences (4, 5).
The arguments noted above are supported by the fact that official programs, nationwide projects and/or governmental regulations have been adopted with the aim of reforming public catering – with special attention paid to the supply of children in schools and elsewhere – in several countries of the world. In table 1, we compare regulations adopted by various European countries to serve different nutritional goals.
Tab. 1. Recommendations for the intake of certain foods in different European countries (6)
|Fruits and vegetables||recommended to eat every day||recommended to eat every day||recommended to eat every day||recommended to eat every day||recommended to eat|
|recommended to eat|
|recommended to eat||recommended at every meal|
|Milk and dairy products||recommended to eat every day||recommended to eat every day||recommended to eat every day||recommended to eat every day||recommended to eat||recommended to eat||no recommendations||recommended to eat every day|
|Constant access to fresh water||recommended ||recommended||no recommendations||recommended||recommended||recommended||recommended||recommended|
|Fish||recommended to eat at least once a week||recommended to eat at least once a week||recommended to eat every day||recommended to eat at least once a week||recommended to eat at least once a week||no recommendations||no recommendations||recommended to eat at least once a week|
|Deep fried food||recommended to limit to max. twice a week||recommended to limit ||no recommendations||recommended to limit to max. twice a week||no require-ment||recommended to limit ||recommended to limit ||recommended to avoid|
|Sweets and pastry products||recommended to avoid||recommended to limit||no recommendations||recommended to avoid/limit||recommended to limit||recommended to limit||recommended to limit||recommended to avoid|
|Chips and salted snacks||recommended to avoid||recommended to limit||no recommendations||recommended to avoid/limit||recommended to limit||no recommendations||recommended to limit||recommended to avoid|
|Beverages||recommended to limit certain beverages ||recommended to limit certain beverages||no recommendations||recommended to limit certain beverages ||water or skimmed milk are recommen-ded ||water is recommen-ded ||recommended to limit certain beverages ||recommended to limit certain beverages|
|Salt||recommended to limit||recommended to limit||no recommendations||recommended to limit||recommended to limit||recommended to limit||recommended to limit||recommended to limit|
To minimize the nutritive and health-related risks associated with public catering, Ministerial Decree No. 37/2014 (IV.30) EMMI was issued. With the exceptions listed in the closing provisions, the Decree was valid from 1st January 2015. As its primary aim was to eliminate problems that were revealed by studies related to nutrition, the Decree includes:
– several recommendations concerning the increase of intake of vegetables, fruit, fibre and calcium and the decrease of intake of salt, sugar and saturated fats,
– recommendations on the different food groups used rather than on the nutrients whereby the Decree follows the most recent nutrition-related recommendations,
– recommendations concerning the intake of different food groups for all the ages,
– daily intake recommendations for nutrients,
– list of substances that are forbidden to be used in edibles,
– requirements concerning written warnings that are to be placed on products with high salt content and sweetened beverages,
– requirement for public caterers to post the menu in a well-visible place; the menu should contain salt content and allergenic ingredients of the foods (as well as their energy content, fat, saturated fat, protein, carbohydrate and sugar content, as introduced from 13 April 2017),
– requirement for public caterers to prepare portioning instructions (the volume and size of portions in grams) that are to be placed in a place visible for the servicing personnel,
– recommended daily intake of milk or a dairy product with an adequate amount of calcium, recommended daily intake of vegetables and fruits (at least one portion of unprocessed vegetable or fruit) and recommended daily intake of grain products of food containing grain (at least one portion of a product made of whole grain),
– recommendations on serving dietetic food; a consumer is required to be served dietetic food if it is medically grounded and prescribed.
The Decree has been valid from 1st January 2015 but a grace period was allowed till 1st September 2015 so that the changes could be introduced gradually (7).
In Slovakia, a Decree No. 330/2009 (VII.14) (in Slovak: 330/2009 Ministerstvo školstva Slovenskej republiky) has been in effect from 2009. The Decree regulates public catering in schools. It provides a plan for the elements on menus, restrictions of the content of some raw materials that are allowed and other principles (8). However, the Slovak Ministry of Education issued a statement in 2015, in which it was underlined that children need even more advanced and healthier nutrition. This resulted in creation of a collection of recipes (”Materiálno – spotrebnènormy a receptúry”), which provides high quality meals for respective age groups, with the ingredient list fitted to make 100 portions, preparation procedures and nutritive content per portion. As the compilation is to be economically friendly, it promotes the use of seasonal and local products. Practical instruction concerning portioning is also included, as well as a chart indicating the loss of nutritional substances resulting from peeling, cleaning, and other preparative methods. This collection of recipes is, in our opinion, of great help to the Slovak catering managers. The centrally issued collection of recipes facilitates the supply of quality food and makes every-day work easier for the caterers (9).
In the course of our study, we aimed to review regulations of other countries adopted for food supply that would have the same function as the Decree No. 37/2014 (IV.30) EMMI in Hungary. We also aimed to compare accessible Slovakian data concerning catering for children with the results of our survey in the context of the efficacy of the governmental regulations. We wished to analyse public catering from the dietetic point of view, which we hoped to conclude by determining what further changes in the sector might be necessary. We believe that, after a thorough assessment of the current situation and identification of existing problems, mistakes and shortfalls, effective interventions may be proposed, whereby – and with the aid of further studies – public health may be improved.
MATERIAL AND METHODS
To collect the data, we used an original questionnaire consisting a closed list of questions. Additionally, we analysed 20 daily menus in each catering facility. 40 Hungarian and 53 Slovak pupils from junior secondary schools (aged between 10 and 16 years and customers of public catering for more than two years) and 183 Hungarian catering managers volunteered to participate in our study. The study was conducted between November 2015 and March 2016. The survey was in Hungarian, and the data was collected in Hungary as well as in parts of Slovakia where Hungarian is spoken.
We processed and aggregated our data and performed statistical tests using Microsoft Excel and the R Project software. We applied the Fisher’s exact test to analyse the distribution of the answers from the Slovakian and Hungarian group separately. We compared the menus available in schools to the applicable legal regulations and analysed them, using the NutriCompÉtrend Sport 3.03 (Hungarian version of NutriCompDiet Sport 3.03) software.
In addition to that, we analysed the process of planning the menus, quantitative list of ingredients, compliance with the daily intake requirements and maximum daily intake requirements of some substances, and external factors influencing the perception of the meal, including the environment of the catering facilities.
The results of or questionnaire, as well as of our analysis of catering facilities, are described below.
66% of the pupils attending included junior secondary schools in Hungary ate meals prepared in school, while the same was true for 51% of their Slovak counterparts. 62% of Hungarian students that ate at school ate only lunch, and 38% of them were provided with three meals a day. In Slovakia, 100% of the students were provided with lunch only, as it is the only option available in Slovakian schools. 81% of the students surveyed in Hungary had been using public catering for more than two years, while the same was true for 67% of Slovakian participants. Having been using public catering for more than two years enabled the students to evaluate the changes in the quality of service during that period.
Efficacy of attitudinal education in forming dietary habits
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