Comparing strategies to improve the implementation of healthy nutrition in kindergartens: a prospective observational study

摘要

Abstract Aim To compare different implementation strategies to improve healthy nutrition in kindergartens. Subjects and methods Healthy 3–6-year-old children and their parents were recruited from kindergartens ( n ?=?56) in two cities in Northwestern Germany. A prospective observational study was conducted including three study groups that followed different implementation approaches to healthy nutrition. In group A, a comprehensive nutrition concept was implemented including environmental changes, educational components and parent involvement. Study group B implemented a child nutrition-related training program for the kitchen staff of the kindergartens. Study group C did not follow a structured implementation approach. A parent-completed food frequency questionnaire assessed the children’s dietary behavior at baseline and 12?months. Change over time and comparison of study groups were analyzed using hierarchical linear regression models. Results Of the 1368 eligible children, 478 completed the baseline assessment (35%). Three hundred seventy-four of these completed the follow-up assessment. Children from group A showed significant reductions in sweet food consumption (?2.4 portions per week, p ?=?0.005) and increased water consumption (+2.4 portions per week, p ?=?0.016) compared to baseline. No significant changes over time occurred in group B and C. A comparison of change over time between the study groups yielded no significant effects. Conclusions This study did not provide evidence for the effectiveness of a particular implementation strategy in comparison to the other strategies. However, contrasts between the study groups were limited by the high levels of nutrition-related activities and availability of healthy foods in all groups.