‘Need for greater focus on fish and legumes in food at day-care institutions’: Danish study

In Denmark, the term ‘day-care’ covers nurseries (children aged 0-3 years), pre-schools (3-6 years) and integrated institutions (0-6 years). While not all day-cares serve meals to children, when they do, they are required to be ‘healthy’.

To help kitchen staff and nursery teachers better understand what ‘healthy’ means for these age groups, the Danish Veterinary and Food Administration published a Guide to healthier food in the day-care institution ​in September last year.

So how inline are Denmark’s day-care centres with these nutritional guidelines? The administration tasked the National Food Institute at the Technical University of Denmark (DTU) to investigate.

The resulting study (available here​​ in Danish) was conducted as a cross-sectional survey examining 1,053 day-care institutions in Denmark.

Lunch tops breakfast​

According to the findings, the food administration’s guidelines were best implemented for lunch and drinks at day-care centres.

“Overall, the survey finds that about 40% of the guidelines are well implemented in Danish day-care institutions with an in-house food supply for at least one meal a day. This means that at least three out of four day-care institutions are meeting the guidelines,”​ Lene M. Christensen, academic officer at the National Food Institute at DTU, told FoodNavigator.

“The best implementation is seen for the guidelines of beverages and lunch meals, where 70% and 60% of the guidelines respectively are well implemented.”​

These meals outperformed breakfast and snacks: the research revealed that less than half of the food agency’s guidelines were adopted by three out of four centres.

DTU stressed, however, that the Danish food administration made health guidelines available for lunches almost 10 years earlier, in 2009, meaning that centres have had time to implement change. Recommendations for breakfast and snacks came in just last year.

Push for more legumes and eggs​

The researchers reported that day-care centres are ‘diligent’ in serving wholegrain products for breakfast and lunch meals. Further, the institutions appeared to have strong focus on reducing the intake of salt and sugar, particularly for the youngest children.

A higher degree of compliance could be achieved, Christensen wrote in the report, if “more day-care institutions use oils and fat spreads – where the main source of fat is vegetable oil – as an alternative to hard fats such as butter, coconut oil and high fat dairy products”. ​

Increased fruit and vegetable intake could also be encouraged, Christensen continued. “Some day-care institutions need to pay attention to the amount of fruit and vegetables, in order to serve at least one-third vegetables and/or fruit in each lunch meal.”​

With regards to animal-based protein, meats were regularly offered at lunchtime. Yet fish was offered in hot dishes less frequently. Just 60% of day-care centres offered fish as a hot meal at least once a week.

Overall, a majority (81%) of day-care centres meet the agency’s recommendations of offering meat, fish, eggs or legumes at least four out of five days.

However, the researchers noted that some institutions offered porridge, soup, or vegetarian dishes without legumes or eggs for lunch too frequently. There is a risk that children will not be satisfied, nor consume enough nutrients, on these days, suggested the DTU.

As a result, the researchers have advised day-care centres to increase the number of servings of fish, legumes, and/or eggs per week. “This is particularly true for day-care centres that offer a diet with less meat,” ​they noted.

A similar issue was observed in the afternoon meals. Denmark recommends that fish or meat, or fish and legumes, be served at least once a week, however just 26% of pre-schools and 45% of nurseries appeared to comply.

“A piece of fruit and bread without fat or cold cuts cannot satisfy your hunger long enough,” ​the researchers noted.

What do these findings mean for policymakers? “By monitoring the compliance to the guidelines the policymakers can learn how to target future efforts aimed at promoting healthy diets in day-care institutions and among pre-schoolers in general,” ​we were told.