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

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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.

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Acknowledgments

The authors would like to thank the organizing institutions of the kindergartens in Bremen and Bremerhaven and the staff from the kindergartens for their support and trustful collaboration. Special thanks are given to the parents and children who participated in the study.

Authors’ contribution

TB and IJ drafted the manuscript. IJ participated in the design of the study. HP participated in the design of the study, performed the statistical analysis, and contributed to data interpretation. SB, SH, and AH contributed to drafting and revising the manuscript and gave intellectual input to the study design. AW contributed to the study design and supervised the study. All authors read and approved the final manuscript.

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Authors and Affiliations

  1. Leibniz Institute for Prevention Research and Epidemiology – BIPS, Achterstrasse 30, 28359, Bremen, Germany

    Tilman Brand, Ingeborg Jahn, Hermann Pohlabeln, Silke Böttcher, Sabrina Hense, Antje Hebestreit & Wolfgang Ahrens

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  1. Tilman Brand
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  2. Ingeborg Jahn
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  3. Hermann Pohlabeln
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  4. Silke Böttcher
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  5. Sabrina Hense
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  7. Wolfgang Ahrens
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Corresponding author

Correspondence to Tilman Brand.

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Ethical standards disclosure

This study was conducted according to the guidelines laid down in the Declaration of Helsinki and all procedures involving human subjects were approved by the ethics committee of the University of Bremen. All children gave verbal consent, and the parents or custodian of each child provided written informed consent for all procedures.

Financial support

The study was funded by the German Federal Ministry of Education and Research (grant no. 01 EL 08 05).

Competing interests

The authors declare that they have no competing interests.

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Brand, T., Jahn, I., Pohlabeln, H. et al. Comparing strategies to improve the implementation of healthy nutrition in kindergartens: a prospective observational study. J Public Health 25, 299–310 (2017). https://doi.org/10.1007/s10389-016-0779-7

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