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ASSESSMENT OF EATING BEHAVIOR IN PUPILS OF MOSCOW AND ALTAI KRAI AND THE ROLE OF FAMILY AND SCHOOL IN THE FOOD CULTURE FORMATION
1National Medical Research Center of Children's Health, Moscow 2Altai State Medical University, Barnaul
Zh.Yu. Gorelova1, S.P. Filippova2, Yu.V. Solovyeva1, A.N. Plats-Koldobenko1, T.A. Letuchaya1, I.P. Saldan2, O.V. Zhukova2
The article presents the data on the assessment of nutrition of children and teenagers in modern conditions. It has been revealed, that the products, meals and ready-to-serve foods provided at school do not satisfy taste preferences of pupils, there lacks the tradition of home and school meal. Thus, it is necessary not only to inculcate eating habits, but also to correct the formed ones - both at school and at home. A considerable role in this process is given to the family.
Key words: eating habits, ration, tradition.
Researches on healthy nutrition of children and teenagers in modern conditions show, that the school menu not always satisfy taste preferences of pupils, there lacks the tradition of home and school meal. Thus, it is necessary not only to inculcate eating habits, but also to correct the formed ones - both at school and at home. A considerable role in this process is given to the family [3, 10].
Research objective
Considering the problem topicaly, there were conducted researches of the
Federal State Autonomous Institution "National Medical Research Center of Children's Health" of the Ministry of Health of the Russian Federation, I.M. Sechenov First Moscow State Medical University, FSBEI HE ASMU of the Ministry of Health of the Russian Federation, aimed at the generalization and analysis of the information on taste preferences of 1-11 form pupils in 220 schools in different Moscow districts (Central Administrative District, Northern Administrative District, North-East Administrative District, Eastern Administrative District, South-East Administrative District, Western Administrative District, North-West Administrative District, Troitsky and Novomoskovsky Administrative Districts, Zelenogradsky Administrative District) and municipal general educational institutions of Altai Krai.
Materials and methods
In Moscow schools there was evaluated the consumption of every current menu item for the moment of study, including products from the school shop and outside the school (favorite courses eaten at home). There were used specifically developed questionnaires. According to the results of the current study there was created the consolidated report (percentage of food consumption) on the basis of questionnaire data obtained during the mon-
itoring of food consumption by pupils of various age groups in canteens of educational institutions. In terms of the data comparison, there were also used the results obtained by the determination of the rate of food waste by means of weighing [3].
The study included the data on 202 385 course helpings, 129 159 out of them - breakfast helpings and 73 226 lunch helpings, given according to the current menu depending on the age of pupils [3, 6, 7, 8].
The number of pupils involved into the study constituted 49 952, the number of questionnaires of pupils and parents - 751, including reports on the quality of food, assessment of subsidized meals, questionnaires on the evaluation of the coffee shop range - 172, observations of teachers, service staff, number of acts on the study management - 567/total - 1318/, the results of monitoring of school nutrition were used for the comparison analysis [1, 3, 4, 9, 10], and the results presented by the Razymovsky MSUTM - Ivanova V.N., Mogilny M.P., 2015 and the computer agency KAP-ITAN, 2012, (http://www.1cp.ru/m7sm/index.php).
In terms of the analysis of the obtained data, there was prepared the "Analytical report on the rationale for the target audience selection and the results of the analysis of eating behavior in pupils of Moscow institutions of general education" for the Moscow Department of Education (See the official website of the Moscow Department of Education).
Results and discussion
According to the monitoring results, taste preferences of pupils can be conventionally divided into three groups:
- dishes, which children practically do not eat; the rate of consumption of these dishes constitutes less than 35% of the total amount of food served;
- dishes, which children eat with pleasure, but in the amount lesser than the amount prescribed in the current menu, the rate of consumption of these dishes constitutes 50-65%;
- dishes, which children eat with great pleasure, the rate of consumption of these dishes constitutes 70% and more.
The number of dishes (totally, there were examined 159 ready-to-serve foods, dishes, food products) according to the current menu considering the rate of consumption was divided into the following proportions: 22% - dishes, which children practically do not eat, 23% - dishes, which children eat with pleasure, 55% - dishes, which children eat with great pleasure. The obtained data prove the necessity and reasonability of the elaboration of new food rations considering modern taste preferences of pupils, including favorite dishes and excluding less consumed dishes at school, considering home nutrition and following daily physiological needs of pupils and principles of succession of home and school nutrition, the so called "school-family" menu [2,3,5].
The elaboration of the new daily ration provides for the reasonability of exclusion of dishes, which consumption rate constitutes less than 50% ("squash spread", "spinach soup", "poached fish", "starch drink", etc.), considering the issue on the reduction of exclusion of dishes important for the adherence to the nutrition value, the consumption of which ranges within the interval of 5065%, with the compensation of the number of nutrients by the addition of other products to the menu. For example, by the reduction of "milk millet porridge" from 150g to 80g the menu should include a cottage cheese pancake for breakfast. Dishes with the rate of consumption over 70% should be left in the new menu without alterations, as they are the most popular according to taste preferences.
Such dishes include: "macaroni baked with cheese", "vegetable salad with beetroot", "salad with fresh tomatoes and cucumbers with vegoil", "borsch with cabbage and potatoes", "Siberian borsch with beef", "beef stroganoff with macaroni", "Leningradsky pickle soup", "potato soup with meatballs", "chicken soup", "chopped chicken meatballs", "goulash", "chopped meat patties (beef)", "chopped chicken patties", "meat pilaf", "mashed potatoes", "boiled rice", porridge "Dru-zhba", "vegetable ragout", "dried apricots compote", "cacao drink with milk", "school pizza", "chocolate cupcake", "cottage cheese pancakes", "cherry pie" and others (87 out of 159 dishes and ready-to-serve foods - 55%).
According to the results of the inquiry, the prevailing products in the day ration bought additionally at retail outside the school and home during the day are chips, carbonate water, bread rolls, sweets. In the school shop - confectionery (20%), bakery (25%), drinks (19%), sandwiches (36%).
In Altai Krai, there was studied the actual nutrition of pupils at the age 12-17 years (n=257) considering additional nutrition at home by means of the analysis of frequency of food consumption, analysis of menus of the organized group [9]. The main group included 125 pupils of schools with modernized technological equipment of the nutrition unit. The group of comparison included 132 pupils of schools without modernized nutrition unit. The parents of pupils (n=257) also took part in the study and answered to the questionnaire: "Information on nutrition and eating behavior". The study revealed, that the modernization of school canteens allowed to improve the structure of nutrition, increase the consumption of a number of nutrients, the quality of nutrition in the main group was subjectively evaluated higher than in the group of comparison (p<0,001).
However, in spite of the conducted measures, the nutrition of 79,8±2,5% of pupils is not balanced by the content of nutrients and energy, which is determined by taste preferences of teenagers and nutrition outside the school [1, 4, 9]. Thus, in the main group, the indexes of the energy share of proteins and fats turned out to be higher, as well as the consumption of meat and meat products, fish, sea products, confectionaries, plant products. At the same time, the compared groups were characterized by low level (lower than the norms of physiological needs) of consumption of meat, milk and dairy products, fish and fish products, eggs, which is also determined by the refusal of pupils in the school canteen of such products as steam-cooked "beef patties", steam-cooked "beef meat balls", steam-cooked "fish patties".
It has been long accepted, that steam-cooked dished cooked in the convection steamer retain nutrients, and as everything is cooked without fat, there is totally realized the concept of healthy food. The choice is, unfortunately, made for such meat products as sausages. In the group of comparison, there was registered insufficient consumption of proteins (7,5%; p=0,0198). The consumption of proteins by young boys constituted 109%, by girls - 93,5% of the norms of physiological needs (p=0,014). In boys 12,5% of calories constitute animal proteins, in girls - 11,5%. In 7,0±1,6% of pupils insufficient consumption of essential ami-no acids, low content of methionine in 58,8±3,1%. In the main group there are observed higher rates of fat consumption (136% of the norms of physiological needs) than in the comparison group - 112,5% (p=0,0216) and sodium (p=0,0242). Herewith, the contribution of school nutrition to the overall fat consumption rate constituted 22,1% and did not differ significantly in both groups (p>0,05).
The consumption of PUFAs constituted 7,3±0,22% of the daily ration calories (by the norm 5-14%), while the correlation of PUFA omega-6/ omega-3 constituted 16:1 due to the shortage
of omega-3 PUFA. In 36,2±3,0% of pupils there was registered the redundancy of the energetic content of the ration. With the age, the fat component in the ration increased: in pupils at the age of 12-14 years, proteins provide 11,8% of calories, fats - 36%, carbohydrates - 52,1%, at the age of 15-17 years: proteins - 12,6%, fats - 38,1%, carbohydrates - 49,3% (optimal rate is 10-15%, 30-32% 55-60% respectively). This is on the background of lower consumption of fruit by teenagers of 15-17 years in comparison with teenagers of 12-14 years, 255 g/day and 322 g/day respectively (p=0,014) and higher consumption of oils and fats by elder teenagers 26g/day in comparison with younger teenagers 18g/day (p=0,036) [9].
The insufficiency of consumption of carbohydrates in the main group and the group of comparison constituted 86,4% and 90,7% of the norm of physiological needs, while in teenagers at the age of 12-14 years, the rate of consumption corresponds to the norm of physiological needs, and in teenagers at the age of 15-17 years, it constitutes 77,5% of the norm (p=0,001). The consumption of dietary fiber: 95% of the norm in boys, 81% of the norm in girls.
Pupils do not follow the recommended frequency of nutrition: 36,2% eat 2-3 times a day; 40,4% -4-6 times; 23,2% do not follow constant frequency and eat from 2 to 6 times a day.
The contribution of school nutrition to the structure of food consumption constitutes 20,8%, which determines the necessity of more active participation of parents (family) in the formation of eating habits and ration of pupils. Moreover, 73% of pupils at the age of 12-17 years, who had taken part in the research, mentioned, that the parents' lifestyle is an example for them. The study of eating behavior of parents revealed: the specific gravity of those, who placed the quality of products on the first position among the characteristics, which they consider by the choice of products, constituted 35%, the second position was occupied by family budget - 19,2%, the third and the fourth positions - taste habits and personal wishes - 14,8%.
The nutrition value, knowledge of the product's usefulness and doctor's advice were rarely placed on the first position. The consumption of fresh fruit and vegetables constituted 114,3 g/day and 128,6 g/day per person respectively, which is lower than the norms recommended by the WHO. Insufficient consumption of milk and curdled dairy products - in 52,5±3,1% of parents, normal - in 17,9±2,4%. During the recent year, 39,9% of parents have been trying to use less salt, among urban population - 45,3±4,4%, among rural population -33,3±4,2% (2I=6,1; p<0,05). 29,2±2,8% constantly use iodine-treated salt, 46,7±3,1% use it sometimes and 24,1±2,7% - very rarely. 13,6% of parents do not follow the recommended frequency of meals and eat 1-2 times a day. Irregular food consump-
tion is registered in 62,3% of respondents, 26,5% have restricted time, 21,4 often overeat. Only 19,8% of parents regularly follow the regime of nutrition and receive vitamin-mineral complexes [9].
Conclusion
Consequently, the assessment of nutrition of children and teenagers in modern conditions and their eating behavior shows, that the number of products, dishes and ready-to-serve foods provided at school do not satisfy taste preferences of pupils (are not liked, are not eaten or eaten incompletely), there lacks the tradition of home and school meal. It determines the necessity of teaching parents, children and teachers to correctly form modern principles and habits of healthy nutrition, to consider eating preferences of pupils and to contribute to teaching the use of "school-family menu".
The example of adults is extremely important in the formation of principles and skills of healthy nutrition, healthy and regular habits. Family breakfasts, lunches and dinners are more pleasant for a child than eating alone. Parents are the main ideal of conduct for a child.
References
1. Analytical report on the state of the school nutritionsystem in the Russian Federation and the progress of implementing the Experiment in all subjects of the Russian Federation (based on the data of the All-Russian monitoring of the organization of school nutrition in 2011).
2. Kuchma V., Gorelova Z. International experience of organizing school nutrition. Current pediatrics. 2008; 7(2):14-22.
3. Kuchma V. R., Gorelova Zh. Yu., Uglov S.Yu., Anufrieva T.A. Sacientific substantiation and development of a two-week daily diet of Moscow students. Issues of school and university medicine and health. 2015; 4: 46-47.
4. Scientific library CyberLeninka: http:// cyberleninka.ru/article/n/konstruirovanie-i-otsen-ka-potrebitelskih-svoystv-funktsional-nyh-pischevyh-produktov-dlya-shkolnogo-pitani-ya#ixzz3c2INQWZM.
5. Zigmund Ye. Which is good for a Swede. Available at: http://www.itogi.ru/ obsch/2011/45/171427.html.
6. Mogilny M.P., Tutelyan V.A., ed. Collection of technical specifications. Collection of recipes for products for students in all educational institutions. Moscow: DeLi print; 2011.
7. Mogilny M.P., Tutelyan V.A., ed. Collection of technical specifications. Collection of recipes for dishes and culinary products for children in pre-school organizations. Moscow: DeLi print; 2012.
8. Titov Ye.I., Mitaseva L.F., Pyltsova L.A. Technological instruction for the production of culinary products for nutrition of children and ad-
olescents of school age in organized collectives. Moscow; 2006.
9. Filippova S.P. Hygienic assessment of pupils nutrition and the effectiveness of the regional program of school feeding modernization in modern conditions (on the example of the Altai Krai). [dissertation]. Omsk, 2015.
10. Kuchma V., Gorelova J. «International experience of organizing school nutrition». The Union of Pediatricians of Russia Scientific Practical Journal. 2009. 60-66.
Contacts
Corresponding author: Filippova Sofya Petrovna, Candidate of Medical Sciences, Associate Professor of the Department of hygiene, ecology and life safety fundamentals of ASMU, Barnaul. 656056, Barnaul, per. Nekrasova, 65. Tel.: (385) 224-97-19. E-mail: sofya.filippova@mail.ru
