Kindergarten and Primary School Nutrition Improvment Program in County of Istria

1. ZAVOD ZA JAVNO ZDRAVSTVO ISTARSKE ŽUPANIJE ISTITUTO DI SANITÀ PUBBLICA DELLA REGIONE ISTRIANA INSTITUTEOF PUBLIC HEALTH COUNTY OF ISTRIA Kindergarten and Primary School Nutrition Improvment Programin Countyof Istria Olga DabovićRac, MD SunčicaMatanić – Stojanović, sanitary engeener AleksandarStojanović, MD Forlimpopoli, June 27, 2014

2. Croatian Recommendations and Guidelines for Children'sHealthCare, Hygiene and Proper Nutrition of Children in Kindergartens www.zzjziz.hr • Children whoare spending 7-8 hours in the kindergarten should consume75% 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%)

3. www.zzjziz.hr Kindergarten Nutrition Improvement Program in Countyof Istria

4. www.zzjziz.hr • Uniqueprogram in Croatia since 1980s • Calculations of the energy and nutrient content of kindergarten menus • Microbiological and sanitary supervision of kindergarten kitchens

5. History www.zzjziz.hr Old Laboratory Evidance and Documentation

6. Hygenic and Sanitary Control Report 1983. and 1984.(KindergartenKamenjak) www.zzjziz.hr

7. Hygienic and SanitaryControlReport, 1984.(Kindergarten Kamenjak) www.zzjziz.hr

8. Daily Consumption of Food, May 1993.(Kindergarten Centar, Kitchen) www.zzjziz.hr

9. Aim of the Program www.zzjziz.hr • 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

10. Analysis of Food Quality www.zzjziz.hr • Sampling and chemical analysis an all-day meal(4 times a year) • Nutritional analysis of weekly menus • Calculations are based on: • KaicRak 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)

11. Microbiological and Sanitary Supervision of Kindergarden kitchen www.zzjziz.hr • Kitchen, dining room, utility room reviewwithepidemiological survey (4 times a year) • Kitchen, utility room, dinning room review • Enviromental sampling – food premisis swabbing • Swabingin the kitchen and on the premises forfood distribution and dining (usually 10 swabs); in regional kindergarten 5 swabs • After each visit the results of all analysis are submitted to kindergarten in a report.

12. Reports www.zzjziz.hr • In report there are comments on the results of chemical and calculated nutritional analysis of daily meals intake, their energy and nutritional valueand content of nutrients: • Protein • Fat • Carbohydrate • Fiber • Saturatedfatty acids • Cholesterol • Vitamin A (retinol) • Vitamin B1 (thiamin) • Vitamin B2 (riboflavin) • Vitamin B3 (niacin) • Vitamin B6 (pyridoxine) • Vitamin C (ascorbic acid) • Sodium • Potassium • Calcium • Magnesium • Phosphorus • Iron and the relationship between the three major nutrients (protein, fat and carbohydrates). • In report we pointto possible failures and deficitandmakerecommendations for their elimination and culinary tipsfor improvement. • Microbiological test procedures for the examination of food and beverages have been standadized and regulated, but nearly every country has its own regulation

13. Example of report www.zzjziz.hr

14. Advices for healthy eating in kindergarten www.zzjziz.hr • Seasonal menu suggestions • Examples of menus are always in line with the Mediterranean diet and traditional Istrian 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

15. Istria County Situation www.zzjziz.hr • 37 central kindergartens prepare the food and in55 regional and 32 private kindergartensthe food is catered from central kindergartens • All kindergartens are subject of hygienic and epidemiological survillance • Financial supportfor program give local communities, cities and municipalities.

16. Nutrition improvment program www.zzjziz.hr • 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

17. www.zzjziz.hr Primary School Nutrition Improvement Program in County of Istria

18. www.zzjziz.hr • In order to improve nutrition in primary schoolswe 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)

19. Program Activities www.zzjziz.hr • In each school we educate staff (kitchen staff, teachers, pedagogues, psychologists, directors). • In each schoolweeducate children about proper nutrition (5thand 6th graders)and give themtheflyers about healthy eating. • Teachers in parent- teacher meetingstalk abouthealthy eating activities in school. • Improving school menus (work in progress) • Menu adaptation according tokitchen possibilities.

20. Presentation ofSchoolMenus (September 2013.) www.zzjziz.hr • Institute of Public Health proposed optimal menus. • Chefs of all schools cooked meals together. • Children tastedand evaluatedwhat they ate.