4. Discussion
WASTED, RECRUITMENT
This cross-sectional intervention study is the first to compare the impact of a prototype and regular 5-day kindergarten meal plan in the same country, in line with national dietary guidelines, on the daily intake of key food groups among 5–6-year-old participants. This study also confirms the hypothesis that meticulously designed kindergarten meal plans can significantly contribute to an adequate daily intake of vegetables, fruits, whole grains, and nuts for the PG participants during weekdays. Furthermore, compared to the nutrition provided outside of kindergartens, kindergarten meals contribute to a more optimal intake of nutritious food groups for both the PG and the CG. Notably, the prototype meal plan’s contribution was more pronounced. The more optimal nutritional value, including higher antioxidant capacity, of prototype kindergarten meals was also confirmed in our previous study [So far, few studies have explored the daily intake of food groups and nutrients in preschool children (≤6 years of age). Among these, several examine the contribution of daily nutrition inside and outside of kindergartens [Since the primary goal of our study was to investigate if a meticulously designed kindergarten meal plan can effectively contribute to enhancing the daily intake of healthy foods among children, we focused mainly on the offer and intake of food groups in kindergartens. All meal plans in the PG and the CG kindergartens were planned according to the Guidelines [Significant differences existed in the proportion of offered vegetables and fruits, whole grains and refined grains with potatoes, and nuts between the PG and the CG meals (Recent research on portion sizes of vegetables and fruits found that larger servings increase children’s daily consumption of these foods; however, larger portions also led to more waste [Considering that children are expected to consume more than 60% of their daily energy and nutritional needs (in Slovenia and some other countries, even up to 75%) in kindergartens, the prototype meal plan satisfied the RDFI requirements concerning almost all parameters discussed, unlike the regular meal plan. In addition to that, the 7-day participants’ dietary record showed that the diet outside the kindergarten contained meagre amounts of vegetables, whole grains, and nuts, agreeing with the EFSA that the intake of healthy food groups is inadequate [As a result of the significantly higher amount of offered vegetables, whole grains, and nuts in the PG meals, it is necessary to highlight the significantly higher content of dietary fiber. A sufficiently high intake of dietary fiber is associated with improved glucose tolerance and lower cardiovascular risk in children [This study also investigated the inclusion and consumption of nuts, a subject that had not been previously addressed in the existing literature. The EFSA has noted that European children, on average, have low or negligible nut consumption [The results of this study coincide with the findings of several other studies [Based on these findings, it is recommended to design kindergarten meals in strict adherence to the guidelines without simplification. While children may not readily embrace certain healthy foods, it is recommended to explore various strategies to enhance their consumption rather than discontinuing their offering [The main strength of this study lies in its comparison of differently designed kindergarten meal plans, all adhering to the same dietary guidelines within the same country. Additionally, a 7-day dietary record, including the amount of food consumed and wasted and covering the weekend, provides a robust insight into the food group intakes in 5–6-year-old children. Precise data on individual food group content were attained by meticulously disaggregating mixed dishes according to weighted recipes. Also, the relatively small number of participants allowed for daily interaction with the children’s parents, teachers, and cooks, preventing errors in filling in the dietary records. The presentation of the data in grams allows for an accurate comparison with other studies. Given the absence of national data on daily food group intake for 5–6-year-olds, the results address this gap, even if they are not representative. Furthermore, the 5-day prototype meal plan is a valuable resource for designing new meal plans and can be readily adapted for other kindergarten settings. This study demonstrates that altering the ratio between vegetables and fruit in favor of vegetables does not lead to significantly increased vegetable leftovers. Nevertheless, it is important to present vegetables in an appealing manner (e.g., small, attractively shaped pieces, attractive colors), opt for vegetables familiar to children, and gradually introduce new varieties.The findings of this study need to be interpreted in light of its limitations. This study faced challenges in participant recruitment, and higher than expected drop-out, particularly related to parental disinterest and the unique circumstances of the COVID-19 pandemic. As the impact of the pandemic could be considered random, and the government reacted uniformly to it, the results remain relevant for the whole population of kindergarten children in Slovenia. The 7-day dietary records of the study participants were consistent with the results of a recent national food survey conducted in 2018 as part of the EU Menu Study [This study shows how a well-planned and meticulously executed meal plan in a kindergarten can drive positive changes in the nutrition of 5–6-year-old children. Despite the limited number of participants, this study’s findings may be relevant to a broader population of 5–6-year-old children in countries where kindergarten nutrition is well established. These findings could stimulate further research in kindergarten nutrition and prompt educational institutions to reevaluate and adjust their meal plans, potentially leading to healthier and more balanced menus. Herewith, it is worth noting that nutrition in kindergartens depends on several factors. One of the most important is the capacity and level of training of nutritionists and cooks who are empowered to design meal plans and prepare healthy meals according to healthy eating guidelines. Therefore, nationally coordinated strategies and measures are needed to achieve these goals.