Browsing by Author "Hyttinen, Charlotta"

Introduction: Information about toddlers’ and pre-schoolers special diets in Finland is scarce. Out of Finnish 1-6-year olds, 63 % attend day care. According to the day care food recommendations, 2/3 of the daily energy needs of children attending full-time day care should be provided during day care hours, which should also fulfil the set nutritional and quality criteria. The day care food services are facing more challenges due to food allergies, and also due to the number of children following religious diets increasing as an effect of increased immigration. Some food allergy-related avoidance diets may be unfoundedly maintained, since children usually recover quickly from food allergies. Aims: The aim of this study was to decipher the prevalence and types of special diets children in the metropolitan area day care centres adhere to, and to investigate what kind of challenges are associated with the general practices considering the apprising of special diets. Additionally, this study aimed to investigate the distribution of special diets in relation to age, gender and city. This study also intended to examine whether a connection between the prevalence of special diets by day care centre and regional socioeconomic factors exists. Material and methods: The cross-sectional data was collected from municipally catered day care centres in Helsinki, Espoo and Vantaa during 2012-2013. 41 day care centres with in total 3 216 children were included in the study. Data of children adhering to special diets was retrieved from special diet-forms, medical certificates and kitchens. Children were divided into different special diet groups based on the reported data. Special diet distributions among other variables were studied with the Pearson Chi square-test. The relation of socioeconomic factors and the prevalence of special diets were tested with the Spearman bivariate correlation analysis. This study is a part of the LILLA-study, which aims to improve the nutrition and allergy-related health of pre- schoolers. Results: Out of the 3 216 children 19 % (n=609) adhered to a special diet. The discovered diets and their prevalences were the following: allergy-related 7,4 % (n=238), lactose-restricted 3,3 % (n=105), ethical or religious diets 7,6 % (n=245), and special diets for other reasons 0,7% (n=21), of the total. A difference was discovered in the special diet distribution according to city (p<0,000): allergy-related diets were most prevalent in Vantaa and ethical or religious diets in Helsinki. A difference was also discovered in the age distribution of special diets (p<0,012): children following an allergy-related diet were younger than children with other special diets (p<0,041). Also, avoiding dairy and egg was discovered to be more common among younger children (p<0,048 and p<0,043). The most often avoided foodstuffs among allergy diets were milk, egg, nuts and almond, and fruit. Lactose-restrictions were more common among older children (p<0,006) and the most prevalent lactose-restriction was a complete restriction. Among ethical or religious diets, diets where pork was forbidden were the most common. Of vegetarian diets, pesco-vegetarian diets were discovered to be the most common. Ethical or religious diets were positively associated with lactose- restricted diets (p<0,000). Special diet-forms required to notify day care centres about special diets were found for 71 % (n=431) of participant following special diets. Medical certificates were found in 53 % (n=156) of the diets where a certificate was demanded. Out-dated information was found in both types of documentation. A reversed connection was discovered in the association between the prevalence of ethical or religious diets and income by day care region (p<0,015, r=-0,379). Conclusions: A fifth of the children in municipal day care centres adhered to a special diet. The most frequent special diets were allergy-related and diets based on ethical decisions or religious beliefs. Allergy diets were mainly exercised in Vantaa and ethical or religious diets in Helsinki. Allergy-related diets were more common among younger and lactose-restricted diets among older children. Ethical or religious diets were associated with lower income. Based on this study, it seems like there is a need for improvements considering the general practices related to special diet apprising in day care centres. Further research about the differences in general practises implemented by each city is ought to be carried out.