Nippers Nutrition
Nippers' Nutrition is a study of the nutritional content of meals provided to children at 10 day care nurseries and a project to change the food offered to their charges in East Sussex.
This project began in March 2007 following the work already being done on healthy eating in schools, this prompted thoughts that it would be interesting to repeat the same sort of work with younger children - in the pre-school nurseries - as this is where, for some youngsters, eating habits both good and bad can be formed.
Over one hundred nurseries across East Sussex were invited to take part in the project looking at the nutritional content and quality of the meals they serve to children in their care participate in the project. Ten nurseries responded and were eager to be involved. Of the ten nurseries that took part, over 600 children are registered and 329 are supplied meals made, or bought in by, the nurseries who took part in the project. The nurseries that took part covered a mixture of geographical and socioeconomic backgrounds, with some providing their own meals and some buying-in their meals from other suppliers.
Although this might not be an area of work that people would normally associate Trading Standards becoming involved with but the joint Food Standards Agency / LACORS LAA Guidance on Food and Health suggests this topic as a possible intervention in the Children and Young People block of Local Area Agreements. This project was very much a community initiative and fell under the County Council’s “Encouraging informed confident consumers and protecting vulnerable consumers” policy steer for the service.
Aims and Objectives
- To provide a snapshot of the nutritional standards of meals being served in childcare assessing them qualitatively against advisory standards.
- Raise awareness of child nutrition and the importance of healthy eating for under 5’s in light of obesity avoidance targets for children.
- Work with nurseries and nursery meal providers to improve nutritional standards where problems discovered.
- Engage in partnership working with local health care providers where possible
- Provide advice and guidance on healthy eating to the nurseries where required via the paediatric dietitian.
Partners
We enlisted the services of a paediatric dietitian as any analysis of a nursery’s menu had to be by someone specialised in that area of nutrition. We were unfortunately unable to obtain a dietitian from our local PCT although the dietitian we used is a consultant paediatric dietitian for the Brighton and Sussex University Hospital NHS trust.
Methodology
All of the nurseries completed a questionnaire providing basic details about the food they supply and their healthy eating policies. One week’s worth of meals and snacks were sampled from each nursery and then submitted for full nutritional analysis by our public analyst laboratory with the results referred onto a paediatric dietitian who then compared them against the guidelines published by the Caroline Walker Trust http://www.cwt.org.uk/ .
The dietitian then produced an easy to understand mini report for each nursery, grading them on their food and providing them with advice and guidance on how to make improvements where necessary.
This Graph is an example of one of the nursery reports showing how nutrients from their food compare against the nutritional guidelines. Green indicates the nutrients that are meeting the recommended guidelines and red indicates those that are not.
We also ran children’s activity events with each nursery and issued parent Information packs that included easy-to-follow guidance on feeding toddlers, encouraging healthy eating and how to read food labels.
Following the reports, the nurseries were provided with further information and advice from the dietitian, through one to one meetings, on the changes necessary to improve their menus. They were also shown how to read food labels and interpret the nutritional information to assist them in purchasing the best products within their budget range. Where necessary, the nurseries have submitted revised menus to reflect the recommended improvements.
The dietitian also compiled a healthy eating advice booklet, a sample menu plan and a recipe ideas booklet for the nurseries to keep for future reference.
All of the nurseries have received a certificate of completion as a result of their participation and successful completion of the project. The report and our advice booklet is available on the East Sussex County Council website.
Promotion
The project has been promoted at local level through the county council website, local press releases, displays at our local life show, member briefings and at Council departmental meetings.
The project has received international and national press coverage in all the main newspapers, BBC news, ITV news and BBC radio 1. It has also been covered in worldwide web discussions.
The results of the survey have unexpectedly attracted wide media interest ranging from the national press to national TV and radio and have been the subject of web discussions across the world thus demonstrating how emotive the subject of child nutrition is.
Resources
Two members of staff worked part time on the project.
Total project costs amounted to £23k comprising Dietitian costs(10 mini reports, 1 for each nursery including nutritional interpretation and 1 overall report), Subsequent 1 to 1 with 8 nurseries plus editing of guidance booklet 1 hour meeting with 9 nurseries; Analysts costs, 50 samples plus report; Printing of parent pack folders; Nippers nutrition logo; Material to accompany activity session (health promotion stickers & paper bracelets for 300 children + 10 posters); Nippers nutrition prize £30 fruit and veg and a toy till - for returning questionnaires; Cost of activity sessions, fruit and veg fresh fruit and veg for 9 nurseries circa 300 kids (each nursery - pineapple, mango, pepper and carrot) Cost of advice brochure.
The Project was funded by East Sussex County Council..
Evaluation
Although this was only a small survey of ten nurseries, there was a common trend amongst the findings in that the majority of nurseries appear to be confused or misinformed about what entails healthy eating for the under 5 age group. Instead of finding that the food supplied was high in calories, fat, saturated fat and salt and low in vegetables and fruit, as suspected, we found that the majority of nurseries had gone to the other extreme and appeared to be providing food that was too low in calories, fat and saturated fat and too high in fruit and vegetables.
Additionally, only 2/10 nurseries supplied the correct portion sizes, with the majority providing too little food. The dietitian concluded from the data supplied from analysis and the questionnaires answered by the nurseries, that it would appear that nurseries were applying principles of adult healthy eating, i.e. low fat, high fibre, to the food they were supplying to young children.The result of this is that some of the nurseries appear to have produced menus and foods which are not suitable for a young diet thus, potentially, putting children at risk of developing nutritional deficiencies.
The use of analysis was critical to the findings of the project as the use of questionnaire data alone or food labelling scrutiny would not have provided a true reflection of the nutritional quality of the foods provided. Many of the dishes appeared fine when written on the menu however upon analysis it appeared that the foods were not nutritionally suitable for young children. Additionally many of the answers to the questionnaires were not reflected in the results of the analysis.
In summary, this project has produced the following conclusions:
- There is a lack of detailed regulation surrounding nutrition for infants and young children.
- There appears to be a lack of knowledge and confusion concerning what constitutes healthy eating for 1-4 year olds.
- There is a lack of information available for childcare providers on infant nutrition.
- There appears to be a tendency to apply the requirements of healthy eating designed for school age children to the 1-4 years of age group who have entirely different requirements.
- Nurseries receive a lot of advice from a range of authorities such as local authority bodies Early Years advisors, OFSTED, dental hygiene advisors and the Food Standards agency, however some of this advice may at times, be conflicting.
- A lot of publicity focuses on a growing obesity problem amongst the young which appears to have made nurseries adopt extreme measures regarding healthy eating. Our findings certainly found an excess of fruit and vegetables being offered and a diet lacking in calories, fats and vital nutrients such as iron. Some nurseries have even gone as far as to ban certain food items such as “crisps, chocolates, sweets, cakes and fizzy drinks”. Whilst the dietitian is in agreement with some aspects of this such as the banning of fizzy drinks, sweets and crisps due to their low nutritional value the occasional chocolate or cake is acceptable as they hold some nutritional value for this age group who have a higher need for calories and fat.
All of the low scoring nurseries have since made changes to their menu’s ranging from altering snacks and switching to more nutritionally suitable products to completely altering their main menu’s and the range of foods on offer. All nurseries that were advised to make changes, submitted their amended menu’s for approval by the dietitian.
Lessons Learned
- The nurseries need comprehensive instructions as to how the samples need to be obtained, i.e. leave aside a complete days food as if for an extra child, even though we collected meals on a daily basis, some of the nurseries were missing items from their menu’s or some of the samples were just too small. This is why daily collection is very important and it is important not to assume that the nurseries will know what to do.
- The dietitian scored the nurseries on their food giving marks out of 10. This proved to be beneficial for those that did well but very detrimental and demoralising for those that scored much lower e.g. our lowest score was 2/10. I would advise against scoring the nurseries, as although it is good at differentiating between the quality of the meals, it does come as quite a shock for some nurseries who think they are doing the right thing but end up scoring poorly. They can then lose interest as they feel that the changes necessary are too daunting and go against everything they know and understand about child nutrition, e.g. that fat and calories are acceptable for children below the age of 5. In this instance, a great deal of work was required to engage with the nurseries and the one to one meetings with the dietitian were paramount.
- The sampling aspect was highly important as some of the meals looked good on paper but did not come out very well on analysis, this is mainly due to the type and quality of ingredients used and manner of cooking.
- It is important to publicise what you are doing with the nurseries amongst the parents as quite often the parents are as confused as the nurseries as to what constitutes healthy eating for the under 5’s. This can be counteracted by issuing parent packs containing advice on the project and healthy eating – we used the FSA guidance for feeding toddlers.
Future Developments
All of the remaining nurseries in East Sussex will be invited to take part in a repeat study and will receive a report of the project with our guidance booklet as a starting point. We have made contact with our early year’s department within the county council and are looking to work in partnership with them on any future related projects.
In terms of the sampling survey, we will wait and see the interest that is generated from the nurseries as a result of our forthcoming mailshot and then determine how best to meet the demand.
Contact Details
Contact Name: Wendy Scott
Job Title: Senior Trading Standards Officer
Phone: 01323 418233 (or 01323 463431)
Email: wendy.scott@eastsussex.gov.uk
Fax: 01323 418227 (or 01323 463430)
Website: www.eastsussex.gov.uk
Organisation: Trading Standards, East Sussex County Council
Address: St Mary's House, St Leonards Road, Eastbourne, East Sussex BN21 3UU
