It is of vital importance to include in preschool children's diets the principles of nutritional prevention of diet-related diseases. It may considerably reduce later in life the risk of many diseases such as atherosclerosis, ischaemic heart disease, hypertension, obesity, type 2 diabetes, osteoporosis and even cancer, since studies have shown a significant relation between dietary habits during childhood and diseases in adulthood (1, 2).

The nutritional value of a preschool child's daily food ration depends largely on the dietary intake during the stay in preschool, since the child spends most of the day in the preschool for five days a week. That is why preschool staff's knowledge about the principles of nutritional prevention of diet-related diseases is so important. Unfortunately, only one study on nutritional knowledge of preschool staff has been published so far (3).

Adequate knowledge in this field is crucial for planning balanced menus and preparing healthy meals for preschool children (4, 5). Moreover, teachers who are knowledgeable about the principles of nutritional prevention of diet-related diseases may influence children's dietary behaviour not only by showing their own behaviour as an example to follow but also by incorporating these principles into the preschool education programme.

The aim of this study was to assess knowledge about nutritional prevention of diet-related diseases in preschool staff from Nowy Sącz and the vicinity.

Questionnaires on nutritional prevention of diet-related diseases were filled in by 84 women, who were employed in eight preschools in Nowy Sącz and the vicinity, including 21 women with vocational education, 33 with secondary education and 30 with higher education who graduated from university. The detailed characteristics of the studied preschool staff were presented in the previous part of this article.

Statistical analysis was carried out by means of the SPSS 12.0 PL for Windows computer programme. The studied population was divided according to educational status. To compare the level of knowledge of the studied staff, the mean percentage of correct answers to all of the questions was calculated.

Table 1 shows the studied preschool staff's correct answers to the questions concerning nutritional prevention of diet-related diseases. Educational status had a statistically significant influence on the answers to thirteen questions: questions 1, 2, 6, 7, 8, 9, 10, 11, 14, 18, 20, 23 and 25. To seven of these questions, questions 1, 7, 8, 9, 18, 20 and 25, correct answers were given by the highest percentage of the staff with higher education. To questions 6, 10 and 23 correct answers were given by all of the staff with higher and secondary education. To question 14 the most correct answers were also given by the staff with secondary and higher education, whereas to questions 2 and 11 the highest percentage of the staff with secondary education knew the correct answer. The lowest percentage of staff with vocational education gave the correct answers to all of the above-mentioned questions.

The mean percentage of correct answers to all of the questions was 74.7% for the staff with higher education, 72.2% for the staff with secondary education, and 59.4% for the staff with vocational education.

Similarly to our previous article, the answers given by the studied staff showed that their knowledge about nutritional prevention of diet-related diseases was varied not only depending on the educational status but also depending on the particular question. The most difficult questions were questions 14 and 19 for all of the studied staff irrespective of their educational status, questions 7 and 9 for the staff with vocational and secondary education, and question 3 for the staff with higher education. The percentages of correct answers to these questions ranged from 4.8% in the case of question 7 for the staff with vocational education to 33.3% in the case of questions 14 and 19 for the staff with higher education and question 14 for the staff with secondary education. Among the answers to the remaining questions it turned out to be difficult to distinguish clear ranges; however, two groups of questions may be suggested. The first one includes those questions to which percentages of correct answers ranged from 42.9% to 70.0% and the second one – from 71.4% to 100.0%. The latter group was suggested based on the British school marking system which classifies a score higher than 70% as a pass mark. In the first group of questions, the lowest percentage of correct answers was given to question 17 by the staff with vocational education (42.9%), and the highest percentage to questions 4 and 13 by the staff with higher education (70.0% each). In the second group of questions, the lowest percentage of correct answers was also given by the staff with vocational education (71.4%) to both questions 8 and 11, whereas the highest percentage was given by the staff with secondary education to questions 6, 10 and 23 and the staff with higher education to questions 6, 10, 18, 23 and 25 (100.0% each).

The level of knowledge about nutritional prevention of diet-related diseases was definitely the lowest in the staff with vocational education. This was shown by the fact that to as many as 21 questions those women gave the lowest percentage of correct answers and that only to one question (no. 12) was the percentage of their correct answers the highest. The knowledge in the staff with secondary and higher education was much better and similar in those two groups. The staff with higher education gave the most correct answers to as many as fifteen questions and the staff with secondary education to thirteen questions, including four questions to which the percentage of correct answers in both groups was the same. However, the staff with higher education gave the lowest percentage of correct answers to three questions, whereas the staff with secondary education gave the lowest percentage of correct answers to only one question. Nevertheless, the mean percentage of correct answers to all of the questions showed definitely that the knowledge of the staff with higher education was the best.

It was very unfavourable that the knowledge about nutritional prevention of diet-related diseases among the women with vocational education was so low compared to the remaining groups of staff. Most of those women were cooks and cook's assistants who prepared meals for the preschool children. It is particularly important that knowledge of the kitchen staff is at a high, professional level since their decisions may have an influence on the nutritional value of the prepared meals and, at the same time, on the health condition of the children who attend the preschool. Therefore, it is essential to incorporate the principles of nutritional prevention of diet-related diseases in the curricula of gastronomy schools, as well as to employ staff with higher education in human nutrition to plan preschool menus or to work out and publish patterns of preschool menus for the use of preschool staff. Moreover, regular training courses for preschool staff should be organised in order to update their knowledge on nutrition.

It is also very unfavourable that the level of knowledge about nutritional prevention of diet-related diseases among the studied preschool staff with vocational education was lower than the knowledge of the parents of children who attended the preschools where the studied staff was employed (6). However, the level of knowledge in this field among the staff with both secondary and higher education was higher than the parents' knowledge (6). It is also disconcerting that the level of knowledge about nutritional prevention of diet-related diseases among the studied staff was lower than in preschool staff from Pabianice (3).

1. The level of knowledge about nutritional prevention of diet-related diseases varied among the studied preschool staff depending on their educational status, with the lowest level of knowledge observed in the staff with vocational education and the highest in the staff with higher education.

2. This study indicates the need to incorporate the principles of nutritional prevention of diet-related diseases in the curricula of gastronomy schools and to organise regular training courses for preschool staff in order to update their knowledge on nutrition.