THE PERCEPTION OF LOW-SALT BREAD AMONG PRESCHOOL CHILDREN  
AND THE ROLE OF EDUCATIONAL PERSONNEL IN CREATING A POSITIVE  
ATTITUDE TOWARDS REFORMULATED FOOD
Boris KOVAC1*, MAJA KNIFIC2
1University of Primorska, Faculty of Health Sciences, Polje 42, 6310 Izola, Slovenia
2Vrtec Koper, Kettejeva ulica 13, 6000 Koper, Slovenia
Received: Mar 10, 2016
Accepted: Jul 7, 2016
Original scientific article
Introduction. The purpose of this study was to identify the possibility of unnoticed reduction in salt content 
of bread as a basic food in the diet of preschool children. The response of children to less salty bread and the 
role of teachers and teacher assistants in the introduction of novelties into children’s nutrition ware studied.
Methods. Using hedonic sensory evaluation in the case of bread, the perception of salty taste and responses 
of preschool children to salt reduction were observed. The combination of quantitative and qualitative data 
analysis obtained from the case study group, composed of 22 preschool children and 66 teachers and teacher 
assistants, was studied. 
Results. The results show that a 30% salt reduction was not registered by the children, while a 50% reduction 
of the salt content, compared to the original recipe, though noted, was not disruptive. The perception of taste 
and development of good eating habits at an early age could be influenced by teachers and teacher assistants’ 
verbal and non-verbal communication.
Conclusion. Salt reduction does not significantly affect the rating of satisfaction with the tested product. 
Educational personnel must be aware of their decisive influence on children’s perception of new and less 
salty products. Such an approach could represent a basis for creating children’s eating habits, which will be of 
particular importance later in their lives. The findings may possibly result in an update of the national nutrition 
policy.
Namen. Namen raziskave je bil opredeliti možnost neopaznega zmanjšanja vnosa soli s kruhom kot osnovnim 
živilom v prehrani predšolskih otrok. S študijo smo želeli ugotoviti odzive otrok na manj slan kruh in opredeliti 
vlogo vzgojnega osebja pri otrokovem sprejemanju prehranskih novosti.
Metode. Na primeru kruha smo s pomočjo hedonskega ocenjevanja raziskovali zaznavanje slanega okusa 
ter odzive predšolskih otrok na zmanjšanje slanosti. V raziskavi smo uporabili kombinacijo kvantitativne in 
kvalitativne analize podatkov, pridobljenih s študijo primera skupine, ki je štela 22 predšolskih otrok in 66 
članov vzgojnega osebja. S pomočjo vprašalnika odprtega tipa smo proučevali opažanje vzgojnega osebja o 
vplivu vrstnikov ter verbalnega in neverbalnega sporočanja vzgojnega osebja na otrokovo sprejemanje novega 
prehranskega izdelka.
Rezultati. Otrokom smo ponudili kruh običajne slanosti ter kruh s 30- in 50-odstotno zmanjšano vsebnostjo 
soli glede na izvorno recepturo. Rezultati so pokazali, da otroci zmanjšanja okusa slanosti za 30%, torej na 
70% izhodiščne vrednosti,  večinoma ne zaznajo. Zmanjšanje slanosti na 50% so otroci zaznali, vendar so 
ponujene različne vrste kruha kljub spremenjenemu okusu dobro sprejeli in niso nobenega vzorca ocenili kot 
nesprejemljivega. Iz rezultatov ankete vzgojnega osebja lahko zaključimo, da osebje lahko moderira izražanje 
vrstnikov v skupini do določenega živila ter s svojo verbalno in neverbalno komunikacijo vpliva na oblikovanje 
dobrih prehranskih navad v zgodnjem otroštvu. 
Zaključek. Manj slan kruh je bil dobro sprejet, zmanjšanja slanosti otroci večinoma niso zaznali, razlike v 
ocenah niso statistično značilne. Vzgojno osebje se mora zavedati svojega odločilnega vpliva na otrokovo 
percepcijo novih in manj slanih izdelkov. Tak pristop k zmanjševanju vnosa soli bi lahko bil osnova za 
oblikovanje prehranskih navad otrok, ki so še zlasti pomembne v poznejših starostnih obdobjih. Ugotovitve bi 
lahko pripomogle k nadgradnji nacionalne prehranske politike.  
ABSTRACT
Keywords: 
preschool children, 
hedonic sensory 
evaluation, 
salt reduction
IZVLEČEK
Ključne besede: 
predšolski otroci, 
hedonska ocena, 
zmanjševanje slanosti
*Corresponding author: Tel: ++ 386 5 662 64 60; E-mail: boris.kovac@fvz.upr.si
10.1515/sjph-2017-0006 Zdr Varst 2017; 56(1): 39-46
39
PERCEPCIJA MANJ SLANEGA KRUHA PRI PREDŠOLSKIH OTROCIH  
IN VLOGA VZGOJNEGA OSEBJA PRI KREIRANJU ODNOSA  
DO PREOBLIKOVANEGA ŽIVILA
Kovac B, Knific M. The perception of low-salt bread among preschool children and the role of educational personnel in creating a positive attitude 
towards reformulated food. Zdr Varst 2017; 56(1): 39-46
© Nacionalni inštitut za javno zdravje, Slovenija. 
1 INTRODUCTION
A carefully chosen diet along with physical activity is 
one of the key factors affecting children’s health and 
well-being. Children’s eating habits are established in 
the preschool period. This process is affected through 
family eating habits as well as preschool nutrition in 
kindergartens, where children usually spend most of their 
days and consume most of their daily meals. The concern 
for the quality of food and eating habits in preschool is 
therefore extremely important for the development and 
formation of eating habits later in life. Children learn 
about food through the direct experience of eating and 
by observing the eating behaviours of others. Children’s 
eating patterns develop during early social interactions 
(1). When children go outside their familiar environments, 
they are influenced by adults and other role models, such 
as educational personnel in kindergartens.
When planning meals for children and youth in preschools, 
schools and other educational care centres, guidelines 
(2) which provide recommendations for creating menus 
for children from the age of one are followed. Practical 
examples are also presented in healthy eating menus 
provided under the heading Practice (3). When developing 
children’s eating habits, we must take into account 
different factors, such as children’s age, geographical 
locations of the places where they live, and the resulting 
characteristics of nutrition, eating habits from the 
immediate environment (family) and children’s wider 
environment (preschool, school). Finally, children’s diet 
is also influenced by religious principles and dietary 
restrictions due to health problems.
The legal basis for the provision of adequate healthy 
food is defined in legislation. The ordering of food for 
adequate meals in public institutions is determined by a 
public procurement procedure, a part of which focuses 
on organic and local products (4). The development of 
appropriate dietary habits in early childhood represents 
an investment in behaviour during adolescence and 
adulthood. Appropriate consumption patterns and physical 
activity prevent chronic non-communicable diseases; 
therefore, the system of mass caterers has to aim for the 
creation of positive approaches to a healthy life.
A large proportion of salt is frequently consumed by eating 
bread as a staple food. This is the reason why the public 
health policy focuses on bread as a means of salt intake 
reduction in the daily diet. The excessive intake of salt 
as a public health problem is mentioned in the context 
of preventing chronic non-communicable diseases, mainly 
cardiovascular diseases. The excessive intake of sodium 
is a risk factor for hypertension, which is also a cause of 
cardiovascular diseases and stroke. Studies also suggest 
a link between excessive salt intake and gastric cancer, 
osteoporosis, asthma, kidney stones and type 2 diabetes 
(5).
The experience of countries that have introduced 
systematic salt intake reduction in the population’s diet 
shows that a systematic and gradual reduction of the 
consumption of salt is needed. Cooperation with the 
food processing industry and mass catering providers 
must also be established, with awareness-raising 
activities for the population carried out simultaneously 
(5). According to World Health Organization (WHO) 
guidelines, the population of Slovenia exceeds the 
maximum recommended daily salt intake in their diets – 
adults by 150%, adolescents by 100% and children by 67%. 
WHO guidelines are already exceeded when consuming 
between 5-6 g of salt per day in staple foods (5, 6).
The National Institute of Public Health of the Republic of 
Slovenia carried out a national survey in 2005 and 2007, 
on the salt content of bread and bakery products, which 
was repeated in 2009/10. Samples of large producers of 
bread from Slovenia were analysed with the research 
showing that the samples contained excessive amounts of 
the recommended target values of salt content. Whereas 
white, mixed, brown, rye and wholemeal bread contained 
an average salt content of 1.4 g/100 g, semi-white bread 
contained 1.2 g/100 g of salt content (7).
In 2012, the WHO published guidelines on sodium intake for 
adults and children. In Slovenia, the National Action Plan 
on reduced salt intake in the diet of people in Slovenia, 
for the period 2010–2020, provides recommendations 
regarding the consumption of sodium (7). The following 
recommendations were set by the WHO: a reduction 
in sodium intake to reduce blood pressure and risk of 
cardiovascular disease, stroke and coronary heart disease 
in adults to less than 2 g/day, which represents 5 g salt/
day. For children, the value is adjusted according to the 
energy requirements of children relative to those of 
adults (8).
Scholars mention several different approaches to 
daily salt intake reductions. One of the approaches is 
‘gradual reduction without the consumer’s knowledge’, 
which refers to the observation that people in general 
are unable to determine the differences between two 
substances in which the difference in salt content is about 
10% (described as ‘Just Noticeable’). However, the ratio 
of the concentration not perceptible to the consumer 
is different for different foods or different preparation 
techniques. A 25% reduction of salt intake in bread without 
affecting the participants’ perception was reported (9), 
but with the remark that all manufacturers should change 
the preparation technology. 
Due to genetic predisposition, people prefer sweet and 
salty tastes. This preference is an unlearned, reflexive 
reaction. The majority of children prefer high-energy-
dense foods to low-energy-dense ones. Infants (under 
4 months) showed neither a favourable nor a dismissive 
attitude towards saltiness. However, infants at the age of 
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4 months start expressing a preference for salty tastes. 
In early childhood, the preference intensifies, so that 
children prefer saltiness more than adults, a pattern that 
is comparable to the sweet preference. Furthermore, 
the degree of salt concentration that children develop 
in childhood determines the level of preferred salt 
concentration in adulthood (1).
Whether a food is liked or disliked is an important 
determinant of food intake, especially among children. 
Salt contributes to the taste of foods and makes them 
more enjoyable (10). Salt level generally has a positive 
impact on the intake of the target foods (11, 12). Research 
found that 4-month-old infants identified and selected 
salted and not plain water, which indicates their salt taste 
perception mechanism, and 6-month-old infants who 
were fed salty starchy table food retained their tendency 
towards salty foods later in childhood (13). Results of the 
research showed that children aged 4 or more prefer salty 
foods to unsalted ones. 
Various studies have shown that after consuming food 
with reduced salt content for a certain period of time (up 
to twelve weeks), the preferred level of salt in food is 
lowered to such a level that foods with high salt content 
become unpleasant for the subjects (14). Results of a 
recent research provide the evidence that promoting 
responsive feeding practices can alter the development of 
eating behaviour, sleep patterns and early self-regulatory 
skills, as well as reduce early obesity risk (15).
Studies also confirm that salt taste preference is formed 
in early childhood. Early experiences also affect food 
behaviour later in life, which should be considered when 
planning salt reduction initiatives (16, 17).
The aim of the research was to determine how children 
respond to the new less salty taste of bread and how 
they adopt it. The survey among educational personnel 
was carried out to define the role of teachers and 
teacher assistants in introducing novelties into children’s 
nutrition. The aim was to explore educational personnel’s 
opinions regarding their own influence and peer influences 
on children’s perception of a food product. 
2 MATERIALS AND METHODS
The survey was divided into phases. In the first phase, 
children and educational personnel evaluated different 
types of bread − rye, white, semi-white, brown, whole 
grain and oat bread, prepared with standard salt contents. 
The salt content in the final product was 1.4 g of NaCl/100 
g, which is the amount that is contained in the commercial 
bread on the Slovenian market. The salt content of 
the bread was reduced by 70% and 50% compared to 
the standard bread, and it was tested using the same 
procedure. The bread samples were baked in the local 
bakery Mlinotest Kruh Koper. The bread was prepared by 
slicing it into 1 cm wide pieces 8 hours after baking. One 
bread sample per day was evaluated. The ratio of volume/
weight determined the structure of bread. Oat, brown 
and rye bread had a compact structure, while white, 
semi white and wholegrain bread had a soft structure. 
Children were given an additional piece of bread to eat 
before their regular meal, which consisted of the usual 
bread with cheese spread. They were encouraged to pay 
attention to the taste, smell, texture, and to remember 
their feelings while eating the bread. After the meal, 
children evaluated their opinions regarding the bread by 
using an emotional facial expression.
2.1 Subjects 
Preschool children were recruited from the kindergarten 
Vrtec Koper, located in the town of Koper. A group of 22 
children aged between 4 and 5 years, and 66 teachers 
and teacher assistants of all age groups of children aged 
between 1 and 5 years participated in the research. The 
study was performed between February and June 2015. 
The average length of service of educational personnel 
was 16.6 years, with 73% of the teachers and assistants 
possessing more than 5 years of experience in working 
with children.
2.2 Methods
The survey method was adapted to the age of the 
children. We took into account that sensory or consumer 
tests for children should respect the range of sensory and 
cognitive abilities of children. As described in previous 
studies (18), the hedonic assessment method using three 
emotional facial expressions is suitable for children at 
this age. The method applied is described by Chen et al. 
(19). A scale of hedonic evaluation was used to interview 
the children using the images of three emotional facial 
expressions: a smiling face J - ‘tasty, I like it’; indifferent 
face K - ‘acceptable, I do not like it a lot, but it is still 
quite good’; sad face L - ‘less tasty, I do not like it’. A 
mixed questionnaire with open-ended and closed-ended 
questions was prepared for the survey to be given out 
to educational personnel. Closed-ended questions are 
shown in Tables 3 and 4. Two open-ended questions were 
given to educational personnel. Open-ended questions 
were answered with a descriptive response, with which 
teachers had to state their observations and opinions 
regarding their own and peers’ role in the creation of 
children’s eating habits.
2.3 Data Analyses
Statistical analysis of the results was evaluated using 
the Fisher exact probability test. It yields a probability 
value p, defined as the probability of the observed array 
of cell frequencies, plus the sum of the probabilities 
10.1515/sjph-2017-0006 Zdr Varst 2017; 56(1): 39-46
42
of all other cell-frequency arrays that are smaller than 
the probability of the observed array. We considered 
statistically significant the results with p-value<0.05.
3 RESULTS 
In the first part of the survey, the participants evaluated 
bread with standard salt content, which is also included 
on the regular children’s menu, while the educational 
personnel evaluated breads with standard salt content in 
the same way as the children; the results are shown in 
Table 1.
More than 60% of the children evaluated all the bread 
types as tasty. Not many of the bread types were evaluated 
as acceptable, with semi-bread evaluated as acceptable 
only once, while wholegrain and white bread did not 
receive any less tasty assessments.  None of the bread 
types was evaluated by children as less tasty. The results 
show that the educational personnel prefer bread with 
a definite taste (oat, brown), compact structure (rye) 
and semi-white bread. The differences among children 
and personnel are not statistically significant except with 
regard to white bread. The educational personnel did not 
perceive white bread to be as tasty as children did, which 
indicates a p-value which is below 0.05, the reason being 
that the educational personnel felt that the white bread 
compared to other types, had a less definite taste, while 
white bread has a soft structure which children like. In 
the second part of the survey, children were presented 
with bread which had a 70% and 50% lower salt content 
compared to the standard recipe. The results are shown 
in Table 2. Satisfaction with bread, despite the reduced 
salt content, is high and comparable with standard salty 
bread.
Table 1. Hedonic evaluation of bread with normal salt content by children and educational personnel.
wholegrain
white
semi-white
oat
rye
brown
children
personnel
children
personnel
children
personnel
children
personnel
children
personnel
children
personnel
15
54
15
45
14
45
13
43
13
46
13
42
0
11
0
14
1
17
4
21
2
18
2
21
0
1
0
7
0
4
0
2
0
2
0
3
100.0
81.8
100.0
68.2
93.3
68.2
76.5
65.2
86.7
69.7
86.7
63.6
0.0
16.7
0.0
21.2
6.7
25.8
23.5
31.8
13.3
27.3
13.3
31.8
0.0
1.5
0.0
10.6
0.0
6.1
0.0
3.0
0.0
3.0
0.0
4.5
0.2776
0.0270
0.1918
0.7250
0.5571
0.2772
p-value
n n n% % %
J K LTYPES OF BREAD
100% salt content
10.1515/sjph-2017-0006 Zdr Varst 2017; 56(1): 39-46
43
The results show that children generally did not detect salt 
reduction or they did not describe it as disturbing. Children 
who evaluated breads using an indifferent emotional facial 
expression did not associate those breads with the concept 
of ‘less salty’. They just explained what they wanted to 
say about the bread they ate. When the salt content was 
50% of the standard content, educational personnel noted 
that children observed a change in taste, and despite the 
difference in taste, evaluated breads as tasty. However, 
fewer types of bread were described as tasty compared to 
the bread with 70% salt content. The assessment of ‘less 
tasty’ was not given to any of the breads. The differences 
in perception of any type of bread with varied salt content 
were statistically non-significant. 
Educational personnel spend a lot of time with children in 
the active part of every day. They monitor their behaviour 
continuously during each meal, and they observe children’s 
reactions to food. This gives staff sufficient knowledge 
and experience to assess how certain characteristics of 
bread impact children’s perception and acceptability 
of a particular product. Table 3 shows observations of 
educational personnel regarding the importance of some 
specific characteristics of bread. 
Table 2.
Table 3.
Hedonic evaluation of different types of bread and salt content by children.
Observations of educational personnel regarding the 
importance of specific characteristics for children’s 
acceptance of bread.
wholegrain
white
semi-white
oat
rye
brown
taste
appearance
colour
smell
texture
100
70
50
100
70
50
100
70
50
100
70
50
100
70
50
100
70
50
65
60
55
43
41
1
6
11
23
25
98.5
90.9
83.3
65.2
62.1
1.5
9.1
16.7
34.8
37.9
15
15
13
15
14
14
14
14
9
13
12
13
13
12
10
13
12
11
0
0
2
0
1
2
1
2
2
4
2
3
2
3
3
2
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
2
0
100.0
100.0
86.7
100.0
93.3
87.5
93.3
87.5
81.8
76.5
85.7
81.3
86.7
80.0
76.9
86.7
80.0
100.0
0.0
0.0
13.3
0.0
6.7
12.5
6.7
12.5
18.2
23.5
14.3
18.8
13.3
20.0
23.1
13.3
6.7
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
0.0
13.3
0.0
0.1060
0.6442
0.8370
0.8982
0.7944
0.3886
p-value
n
nn
n n%
%%
% %
J K L
TYPES OF BREAD Salt 
content
less importantimportant
The results show that three characteristics were assessed as 
the most important − characteristics that also form the first 
impression of a food product, namely taste, appearance 
and colour. However, bread is a very complex food from 
the visual and organoleptic point of view, and it is difficult 
to define correlations among children’s answers as shown 
in Table 1, and observations of educational personnel as 
defined in Table 3.
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44
Children imitate each other, therefore peer influence 
is certainly present when children are eating or talking 
about food. Observations of the educational personnel 
regarding peer influence and the effect of verbal and 
nonverbal communication of the educational personnel 
on the children’s acceptance of food products are given 
in Table 4. Two open-end questions were posed − the first 
to evaluate peer influence and the second to evaluate the 
effect of educational personnel’s verbal and nonverbal 
communication on children’s acceptance of food products. 
Qualitative answers are shown in the table below.
• Children can sense educational personnel’s reaction 
to a meal only by observing their facial expressions. If 
the opinion is negative, it reflects in the whole group;
• teachers and teacher assistants are role models for 
children;
• verbal and non-verbal communication is very 
important. Educational personnel must try all the 
food that is offered to children and must approve it 
even if they do not like it;
• educational personnel must present food to children 
in an appealing way, so that they want to taste it;
• educational personnel’s appropriate attitude to food 
and encouragement can help a lot, inducing children 
to try the food, and be proud of themselves if they 
are also praised;
• it is important to convince children to at least try the 
food/product.
The results of the closed-ended questionnaire indicate 
that 78% of the educational personnel attach strong 
importance to their educational role in eating habits. The 
analysis of the open-ended responses, which encompass 
the experience of working with children, shows that 
educational personnel can affect children’s perception of 
food.
4 DISCUSSION
The majority of children in Slovenia (92%) aged between 
3 and 5 years attend kindergartens; however, the 
percentage of children aged between 1 and 5 years is 
lower, comprising only 77% (20). This means that children 
experience nutrition in both domestic and kindergarten 
environments. Children’s responses to bread with 
unreduced standard salt content show they prefer white, 
semi-white and wholegrain bread, perhaps because of its 
soft structure. Brown, rye and oat bread were described 
as tasty (with a happy emotional facial expression); 
however, the percentage of breads evaluated with a lower 
mark was slightly higher. Preschool children primarily 
notice physical characteristics, such as colour, shape and 
structure in forming an opinion about certain foods (14). 
None of the children marked any of the breads as less 
tasty. There is no statistical difference in the evaluation 
of standard salted bread types between the children and 
educational personnel, except for white bread where the 
p-value is lower than 0.05.
We wanted to determine whether children find the bread 
with reduced salt content different enough to assess it as 
worse than the bread with normal salt content. Children 
were not previously told to pay attention to the saltiness 
of the product. They evaluated the product as a whole. 
Using emotional faces, they only explained what they 
wanted to say about the bread they were eating. Despite 
Table 4. Observations of educational personnel regarding peer 
influence, and the effect of verbal and nonverbal 
communication of educational personnel on children’s 
acceptance of food products.
Peer influence
strong influence
mild influence
no influence
Educational personnel influence
strong influence
mild influence
no influence
42
15
9
52
8
6
63.6
22.7
13.6
78.8
12.1
9.1
n %
Peer influence is important; its negative influence can 
be mitigated by educational personnel. Two open-
end questions were asked, the first one to evaluate 
peer influence and the second one to evaluate the 
effect educational personnel’s verbal and nonverbal 
communication had on children’s acceptance of food 
products. The teachers stated the following observations:
• Peer influence is less visible in toddlers;
• influence varies according to the age of children;
• children taste a meal if they see others eating it, or 
they reject it when other children do the same;
• children imitate each other, therefore peer influence 
is certainly present;
• children are not under so much peer influence when in 
a guided group. However, personnel must be careful 
when talking about a specific meal;
• educational personnel have to reduce negative peer 
influence and, as an example, influence children’s 
behaviour during meals.
Educational personnel’s opinions regarding the 
importance of their role in persuading children to accept 
some foods or food products show that they are aware of 
the educational importance of kindergarten meals. The 
teachers stated the following observations:
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45
the limitations of the hedonic evaluation, the results give 
us a vital answer − children like bread with reduced salt 
content. The statistical analysis of data using the Fisher 
exact probability test confirmed that evaluations of 
low-salt bread do not show deviations from the normal 
ratings of the same type of bread. These findings partially 
correspond to the results of the study by Girgis et al. 
(9), which showed that a 25% salt reduction can be made 
without being noticed. However, the results of our study 
indicate that children also accept breads with only 50% 
salt content, although results of some previous studies 
suggest that children prefer salty foods to unsalted ones 
(12). Children did not associate those pieces of bread with 
the concept of ‘less salty’.
The environment children live in, in particular persons 
they come in contact with, is also important in 
formulating children’s eating habits and influencing 
children’s acceptance of specific tastes. The effectiveness 
of a child’s role model in food preferences depends on 
the relationship between the child and the role model. 
A role model is a person who serves as an example by 
influencing others. For many children, the most important 
role models are their parents and caregivers. Children 
look up to different role models in order to help shape 
their behaviour in school, their relationships, or when 
making difficult decisions. Children also look up to other 
relatives, teachers and peers. Important role models for 
preschool children are older people or celebrities, and 
other characters that children admire. These people are 
more effective role models than unknown people (11). 
Peers in kindergarten play an important role in shaping 
children’s eating habits. It is not uncommon for children 
to eat certain types of food that they initially decline 
at home. Children can also reject dishes simply because 
they are sitting next to their peers eating the meal with 
pleasure (21). Other surveys stress the influence of the 
environment outside the kindergarten; however, the 
results of this survey and its qualitative answers indicate 
that educational personnel have a significant impact on 
children’s preference for a specific product. This influence 
can help reduce the salt intake in the daily diet of children 
and also adjust children to a lower salt diet later in life.  
5 CONCLUSIONS
We found that salt reduction does not affect the rating 
of satisfaction with the offered product significantly. This 
was a step towards reducing salt intake in the daily diet of 
children, and adapting children to less salty dishes. 
The environment outside the kindergarten has an 
important impact on children. The role of adults, parents 
and teachers is to help children develop healthy eating 
habits. We can conclude that educational personnel are 
aware of their important educational role in child-feeding 
activities, and that they have a significant influence on 
children’s preference of a specific product. 
The success of the salt reduction project at the national 
level definitely depends on the macro-environment. 
Continuous education of all people involved regarding 
the importance of salt intake reduction in the daily diet 
and its effects on human health is necessary, the most 
important being educational personnel on one hand, and 
parents on the other.
CONFLICTS OF INTEREST
The authors declare that no conflicts of interest exist.
FUNDING 
This study was not financed.
ETHICAL APPROVAL 
All the data analysed in this study were collected at 
the Vrtec Koper kindergarten, without collecting any 
information regarding the identity of individuals. Parents 
gave permission for their children’s participation in the 
study. The study was conducted in accordance with the 
International Code of Medical Ethics of the World Medical 
Association (Declaration of Helsinki).
REFERENCES
1. Savage JS, Fisher JO, Birch LL. Parental influence on eating behavior 
conception to adolescence. J Law Med Ethics 2007; 35: 22–34.
2. Gabrijelčič Blenkuš M, Pograjc L, Gregorič M, Adamič M, Čampa 
A. Smernice zdravega prehranjevanja v vzgojno–izobraževalnih 
ustanovah, Ljubljana: Ministrstvo za zdravje, 2005.
3. Hlastan Ribič C, Maučec Zakotnik J, Koroušić Seljak B, Pokorn 
D. Praktikum jedilnikov zdravega prehranjevanja v vzgojno–
izobraževalnih ustanovah. Ljubljana: Ministrstvo za zdravje, Zavod 
Republike Slovenije za šolstvo, 2008.
4. Ministrstvo za kmetijstvo in okolje, Ministrstvo za finance. Priporočila 
za javno naročanje živil. Available Feb 15, 2016 from:
5. http://www.mkgp.gov.si/fileadmin/mkgp.gov.si/pageuploads/
podrocja/Kmetijstvo/Promocija_SI_kmetijstva/priporocila_JN_zivil.
pdf.
6. Hlastan Ribič C. Sol – javno zdravstveni problem. In: XX. Strokovni 
sestanek sekcije za hipertenzijo. Ljubljana: Slovensko zdravniško 
društvo, Sekcija za hipertenzijo, 2011: 862-75.
7. Hlastan Ribič C, Pokorn D, Poličnik R, Kulnik D. Prehranski vnos 
predšolskih otrok. Slov Pediat 2006; 13: 25-31.
8. Ministrstvo za zdravje Republike Slovenije. Nacionalni akcijski načrt 
za zmanjševanje soli v prehrani prebivalcev Slovenije za obdobje 
2010–2020. Available Feb 15, 2016 from: www.dlib.si/stream/
URN:NBN:SI:DOC-ZF4CAGWN/531c3a0f.
10.1515/sjph-2017-0006 Zdr Varst 2017; 56(1): 39-46
46
9. WHO. Guideline: sodium intake for adults and children. Geneva: 
World Health Organization, 2012. 
10. Girgis S, Neal B, Prescott J, Prendergast J, Dumbrell S, Turner C, et 
al. A one-quarter reduction in the salt content of bread can be made 
without detection. Eur J Clin Nutr 2003; 57: 616-20. 
11. Birch LL. Development of food preferences. Annu Rev Nutr 1999; 19: 
41-62. 
12. Bouhlal S, Issanchou S, Nicklaus S. The impact of salt, fat and sugar 
levels on toddler food intake. Br J Nutr 2011; 105: 645-53. 
13. Beauchamp GK, Cowart BJ. Preference for high salt concentrations 
among children. Dev Psychol 1990; 26: 539-45. 
14. Stein LJ, Cowart BJ, Beauchamp GK. The development of salty taste 
acceptance is related to dietary experience in human infants: a 
prospective study. A J Clin Nutr 2012; 95: 123-29. 
15. Matheson D, Spranger K, Saxe A. Preschool children’s perceptions of 
food and their food experiences.  J Nutr Educ 2002; 34: 85-92.
16. Birch LL. Learning to eat: behavioral and psychological aspects. 
Nestle Nutr Inst Workshop; 2016; 85: 125-34.
17. De Simone J, Beauchamp GK, Drewnowski A, Johnson GH. Sodium in 
the food supply: challenges and opportunities. Nutr Rev 2013; 71: 
52-9.
18. Skinner JD, Carruth BR, Wendy B, Ziegler PJ. Children’s food 
preferences: a longitudinal analysis. J Am Diet Assoc 2002; 102: 
1638-47. 
19. Guinard JX. Sensory and consumer testing with children. Trends Food 
Sci Tech 2001; 11: 273-83.
20. Chen AW, Resurreccion AVA, Paguio LP. Age appropriate hedonic 
scales to measure food preferences of young children. J Sens Stud 
1996; 11: 141-63.
21. Predšolska vzgoja in izobraževanje v vrtcih, Slovenija, šolsko 
leto 2012/13 – končni podatki. Available Apr 11, 2016 from: 
http://www.stat.s i/StatWeb/glavnanavigacija/podatki/
prikazistaronovico?IdNovice=5386.
22. Roberts M, Pettigrew S. Psychosocial influences on children’s food 
consumption. Psychol Market 2013; 3: 103-20.