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ZAVOD ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJE ISTITUTO DI SANITÀ PUBBLICA DELLA REGIONE ISTRIANA INSTITUTE OF PUBLIC HEALTH COUNTY OF ISTRIA

Kindergarten and Primary School Nutrition Improvment Program in County of Istria Olga Dabović Rac, MD Sunčica Matanić – Stojanović, sanitary engeener Aleksandar Stojanović, MD Forlimpopoli, June 27, 2014

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Croatian Recommendations and Guidelines for Children's Health Care, Hygiene and Proper Nutrition of Children in Kindergartens

Children who are spending 7-8 hours in the kindergarten should consume 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%) snack (10%) lunch (30%) snack (10%)

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Kindergarten Nutrition Improvement Program in County of Istria

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Unique program in Croatia since 1980s Calculations of the energy and nutrient content of kindergarten menus

Microbiological and sanitary supervision of kindergarten kitchens

History

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Old Laboratory Evidance and Documentation

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Hygenic and Sanitary Control Report 1983. and 1984.

(Kindergarten Kamenjak)

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Hygienic and Sanitary Control Report, 1984.

(Kindergarten Kamenjak)

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Daily Consumption of Food, May 1993.

(Kindergarten Centar, Kitchen)

Aim of the Program

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To improve the quality of kindergarten food To enhance the health education of children, their parents, kitchen staff and teachers To promote healty eating patterns in childhood and by doing so to promote optimal health and prevent some health problems in later year

Analysis of Food Quality

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

Nutritional analysis of weekly 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 Kindergarden kitchen

Kitchen, itchen dining room, utility room review with epidemiological survey (4 times a year) Kitchen, utility room, dinning room review Enviromental sampling – food premisis swabbing

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

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

Reports

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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:

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

In report we point to possible failures and deficit and make recommendations for their elimination and culinary tips for improvement. improvement Microbiological test procedures for the examination of food and beverages have been standadized and regulated, but nearly every country has its own regulation

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Example of report

Advices for healthy eating in kindergarten

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Seasonal menu suggestions Examples of menus are always in line with the Mediterranean diet and traditional Istrian diet. diet Every menue contains folowing food: fish various meat seasonal fruit, vegetables and legumes cereals whole grains herbs

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

Our suggestion is to boil and stew food instead of deep fat frying

Istria County Situation

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37 central kindergartens prepare the food and in 55 regional and 32 private kindergartens the food is catered from central kindergartens All kindergartens are subject of hygienic and epidemiological survillance Financial support for program give local communities, cities and municipalities. municipalities

Nutrition improvment program

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Team work Epidemiologists, sanitary engineers, food technology engineers, biologist, chemical technicians In kindergarten: cooperation with kindergarten staff teachers, nurses, kitchen staff kindergarten, parents, suppliers, manufacturers Local community support

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Primary School Nutrition Improvement Program in County of Istria

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In order to improve nutrition in primary schools we proposed optimal menus.

Barriers in program implementation are: lack of kitchen staff lack of education for kitchen staff the primary role of schools in education and not in the preparation of meals limited financial resources lack of motivation of parents and school staff.

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

Program Activities

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

In each school we educate children about proper nutrition (5th and 6th graders) and give them the flyers about healthy eating. eating Teachers in parent - teacher meetings talk about healthy eating activities in school.

Improving school menus (work in progress) Menu adaptation according to kitchen possibilities. possibilities

Presentation of School Menus (September 2013.)

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Institute of Public Health proposed optimal menus.

Chefs of all schools cooked meals together.

Children tasted and evaluated what they ate.