# Parental Perceptions of Healthy Eating and Actual Nutrient Intake: Analysis of the Nutritional Status of Children Aged 1–6 Years in Urban Areas of Central Kazakhstan

## TL;DR

This study finds that young children in Central Kazakhstan have poor diets with low nutrients and high sodium, despite parents' beliefs about healthy eating.

## Contribution

The study reveals a significant perception-intake gap in early-childhood nutrition and identifies specific nutrient deficits in urban Kazakhstani preschoolers.

## Key findings

- Many preschoolers in Central Kazakhstan have diets lacking in fats, fiber, vitamin C, calcium, and iron.
- Children aged 3–4 years show the most severe clustering of nutrient shortfalls.
- Parental dietary priorities weakly correlate with children's actual nutrient intakes.

## Abstract

Public health relevance—how does this work relate to a public health issue?
This study provides detailed, age-stratified data on actual macro- and micronutrient intakes in urban children aged 1–6 years in Central Kazakhstan, a region where early-childhood nutrition is critical but remains poorly documented.We show that many apparently healthy preschoolers have diets with systematic deficits in fats, dietary fiber, vitamin C, calcium, iron, and energy (in specific age groups), alongside persistent excess sodium, highlighting an under-recognized form of nutritional risk.

This study provides detailed, age-stratified data on actual macro- and micronutrient intakes in urban children aged 1–6 years in Central Kazakhstan, a region where early-childhood nutrition is critical but remains poorly documented.

We show that many apparently healthy preschoolers have diets with systematic deficits in fats, dietary fiber, vitamin C, calcium, iron, and energy (in specific age groups), alongside persistent excess sodium, highlighting an under-recognized form of nutritional risk.

Public health significance—why is this work of significance to public health?
The results identify younger preschoolers (especially 3–4-year-olds entering kindergarten) as the most vulnerable subgroup, with clustering of multiple macro- and micronutrient shortfalls that may affect growth and future noncommunicable disease risk.Weak, non-significant correlations between parental dietary priorities and children’s actual nutrient intakes reveal a perception–intake gap, suggesting that current public messages about “healthy eating” do not effectively translate into nutritionally adequate diets for young children.

The results identify younger preschoolers (especially 3–4-year-olds entering kindergarten) as the most vulnerable subgroup, with clustering of multiple macro- and micronutrient shortfalls that may affect growth and future noncommunicable disease risk.

Weak, non-significant correlations between parental dietary priorities and children’s actual nutrient intakes reveal a perception–intake gap, suggesting that current public messages about “healthy eating” do not effectively translate into nutritionally adequate diets for young children.

Public health implications—what are the key implications or messages for practitioners, policy makers and/or researchers in public health?
Public health programs and preschool feeding policies in Central Asia should move beyond a primary focus on “avoiding unhealthy foods” and explicitly promote adequate intake of fats, dietary fiber, vitamin C, calcium, and bioavailable iron in early-childhood diets, while reducing sodium.The age-specific patterns we document can be used to target counseling, menu revision and nutritional surveillance toward families and preschool institutions where multiple nutrient deficits are most likely, particularly in children aged 3–4 years.

Public health programs and preschool feeding policies in Central Asia should move beyond a primary focus on “avoiding unhealthy foods” and explicitly promote adequate intake of fats, dietary fiber, vitamin C, calcium, and bioavailable iron in early-childhood diets, while reducing sodium.

The age-specific patterns we document can be used to target counseling, menu revision and nutritional surveillance toward families and preschool institutions where multiple nutrient deficits are most likely, particularly in children aged 3–4 years.

Parental perceptions of healthy eating often diverge from children’s actual diets, but this gap is poorly documented in Central Asia. We examined how parents’ priorities for key food groups relate to nutrient intakes in 390 urban children aged 1–6 years in Central Kazakhstan. In a cross-sectional study, parents completed a 24 h multiple-pass dietary recall and rated the importance of fats and sweets, meat and fish, dairy, vegetables and fruits, and bread and potatoes on 5-point scales. Nutrient intakes were calculated using software, compared with national DRIs, and analyzed using rank-based tests and Spearman correlations. Parents reported near-ceiling priority for restricting fats and sweets and consistently high priority for bread and potatoes, whereas vegetables, fruits, meat/fish, and dairy were rated moderately important, with dairy under-prioritized in 1–2-year-olds. On the recalled day, median intakes of fat, dietary fiber, vitamin C, and calcium were below national recommendations at all ages, and median intakes of iron, thiamine, and niacin were particularly low at 3–4 years, while sodium intake exceeded recommended levels; the 3–4-year group showed the most pronounced clustering of shortfalls. Prevalence estimates indicated that most children had intakes below recommendations for dietary fiber and calcium and above recommendations for sodium, underscoring population-wide nutritional imbalance. Across all scales, parental priorities showed only weak, non-significant associations with nutrient intakes (|r| < 0.11). These findings indicate a perception–intake gap and support interventions that ensure adequate fats, fiber, vitamin C, calcium, and bioavailable iron in preschool diets.