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Open Access 25-04-2024 | Biomarkers | RESEARCH

Effect of antioxidant-rich kindergarten meals on oxidative stress biomarkers in healthy 5–6-year-old children: a randomized controlled trial

Authors: Maja Berlic, Mojca Korošec, Žiga Iztok Remec, Vanja Čuk, Tadej Battelino, Barbka Repič Lampret

Published in: European Journal of Pediatrics | Issue 7/2024

Abstract

As children spend up to 9 h a day in kindergarten, the main purpose of our study was to evaluate the effect of antioxidant-rich kindergarten meals on oxidative stress biomarkers (OSBs) in healthy children. In the randomized control trial with a follow-up, healthy 5–6-year-old children from six kindergartens were randomly divided into a prototype group (PG, n = 40) and a control group (CG, n = 17). PG followed a 2-week antioxidant-rich kindergarten meal plan (breakfast, lunch, and two snacks), and CG followed their standard kindergarten meal plans. Outside the kindergartens, participants ate as usual. We used a consecutive 7-day dietary record inside and outside the kindergarten and the national dietary assessment tool OPEN to assess the total dietary antioxidant capacity (dTAC) of the consumed foods. Malondialdehyde (MDA), 8-hydroxy-2-deoxyguanosine (8-OHdG), and four F2-isoprostane were measured in fasting urine on days 1 and 15. We also measured total antioxidant power (PAT) and hydroperoxides (d-ROMs) in fasting serum on day 15 and obtained the value of the oxidative stress index (OSI). We used a Welch two-sample t-test and multiple regression analysis to compare the prototype and control groups and a nonparametric Wilcoxon signed rank exact test to compare pre- and post-intervention results in urine. Antioxidant-rich kindergarten meals contributed to a significantly (p < 0.05) higher intake of dTAC in PG participants compared to standard meals in CG participants (8.6 vs. 2.8 mmol/day). We detected a negative correlation between dTAC intake and d-ROMs and between dTAC intake and OSI (r = − 0.29, p = 0.043 and r = − 0.31, p = 0.032, respectively). A significant decrease in urinary 8-iso-15-prostaglandin-F-2 alpha was detected in PG participants between days 1 and 15; however, no other intra-individual significant differences in urinary OSBs were found.

Conclusion: Antioxidant-rich food in kindergarten is warranted due to its potential health-protective effect. Additionally, we present original data on the average levels of urinary and serum OSBs in healthy 5–6-year-old children.

Trial registration: The study was registered at ClinicalTrials.gov, on February 5, 2020 (https://clinicaltrials.gov/ct2/show/NCT04252105).

What is Known: • Kindergartens are recognized as promising environments for public health measures. • A diet rich in antioxidants can reduce OSBs and, consequently, the risk of developing NCDs.
What is New: • Antioxidant-rich kindergarten diet can ensure a protective intake of dTAC in children. • Original data on serum oxidative stress biomarkers (d-ROMs, PAT, and OSI) and urinary oxidative stress biomarkers (MDA, 8-OHdG, and F2 isoprostanes) in healthy 5–6-year-old children.

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Title: Effect of antioxidant-rich kindergarten meals on oxidative stress biomarkers in healthy 5–6-year-old children: a randomized controlled trial
Authors: Maja Berlic
Mojca Korošec
Žiga Iztok Remec
Vanja Čuk
Tadej Battelino
Barbka Repič Lampret
Publication date: 25-04-2024
Publisher: Springer Berlin Heidelberg
Keyword: Biomarkers
Published in: European Journal of Pediatrics / Issue 7/2024
Print ISSN: 0340-6199
Electronic ISSN: 1432-1076
DOI: https://doi.org/10.1007/s00431-024-05576-6

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