Unhealthy and healthy food consumption inside and outside of the school by pre-school and elementary school Mexican children in Tijuana, Mexico

The Ecuadorian School Food Environment: Association With Healthy and Unhealthy Food and Beverage Consumption and BMI

BACKGROUND

Schools can play an important role in promoting healthy child diet and body weight. However, this issue is understudied in Latin American and other populations undergoing nutrition and epidemiologic transition.

OBJECTIVES

2018 Ecuadorian National Health and Nutrition Survey data were used to examine the association of school food sources with healthy and unhealthy food intake and body mass index (BMI) in primary (n = 12632) and secondary students (n = 6617).

METHODS

Data on school food environment characteristics were collected by questionnaire, intakes of fruits, vegetables, plain water, sweetened beverages, processed snacks, and fast foods by food frequency questionnaire, and BMI using measured weight and height. Data were analyzed using multivariable methods.

RESULTS

The major school food sources were competitive foods sold by commercial outlets (73%), School Breakfast Program (SBP; 52%), and home-packed items (37%). Most (69%) competitive food outlets sold fruits and vegetables but only 44% offered free clean drinking water and 60% sold prohibited "red traffic light" foods. Primary and secondary students who bought competitive foods consumed sweetened beverages, processed snacks, and fast food more frequently than nonpurchasers (P = .0001). Those who packed home foods had higher fruit and vegetable intakes (P = .0001). Plain water intakes were reduced among all SBP participants (P = .0001). However, primary students in the SBP consumed fast foods less frequently (P = .0001) and had lower average BMI and odds for being obese compared to nonparticipants (P = .0001).

CONCLUSION

The findings from this nationally representative study underscore the important contribution of the school food environment to child nutrition.

Nutritional Characteristics, Sites of Origin, and Cost of Foods Consumed during School Hours and Their Relationship to Nutritional Status of Schoolchildren in Mexico City

Access, nutritional characteristics, preferences, and cost can affect food intake at school. A cross-sectional study was performed to determine the nutritional characteristics, sites of origin, and cost of foods consumed during school hours. Three hundred and sixty-nine children from five public elementary schools in Mexico City participated. The children gave information about the foods that they consumed five days out of the week during school hours, including the place of acquisition, cost of the food, and portion size. Anthropometric measurements of height and weight of the children were taken. Caloric consumption and percentage of recommended daily energy intake from food during school hours was determined. Children were 10.9 ± 0.9 years old; 55.6% were girls, 26% were overweight, 23% were obese, and 3.3% were of low height for age. The average calorie intake was 515 kilocalories (kcal) (boys, 535 kcal; girls, 476 kcal, p = 0.051); calorie intake was higher when school meal intakes included foods from home, school, and outside of school. No significant differences were found in calorie intake by children’s nutritional status. The cost in Mexican pesos per 100 kcal consumed showed differences according to the nutritional status of the children; it was 4.0 Mexican pesos for children with normal weight and 4.2 and 3.8 pesos in children who were overweight or obese, respectively. The information obtained in this study should be used to provide nutritional guidance. The food portion size intake during school hours should be reduced, and the food should come from one or at most two sites, because each extra food represents an increase in the total kilocalorie intake.

Impact of a Nutrition-Related Community Intervention on the Quantity and Quality of Children's School almuerzo

Foods and beverages that schoolchildren carry in their lunchboxes have high energy values but lack plain water, fresh fruits and vegetables. A nutrition-related community intervention on the quantity and quality of school almuerzo was performed, in which four primary schools participated, as part of two groups: 225 children in the intervention group (IG) and 177 children in the control group (CG). The parents from the IG had access to a website where they could consult information on eating habits and physical activity or school almuerzo menus. They were sent weekly text messages on their mobile phones and attended in-person sessions. Anthropometric measurements and surveys were performed in both groups at the start of the study, as well as after 6 and 12 months. The school almuerzo was assessed by recording foods that the children brought in their lunchboxes. At baseline, 88% of children brought a school almuerzo, 37% fruit, 17% vegetables, 40% plain water and 50% sweet drinks. In both groups, 50% of children brought a school almuerzo with an energy value above the recommended value (>340 kcal) during follow-up; however, the percentage of children who brought sweet drinks decreased (p < 0.05), with sweet drinks contributing between 26% and 33% of the calories in the school almuerzo. In the IG, the quantity in milliliters of plain water increased at the end of the follow-up period (p = 0.044). From the point of view of food-and-beverage quantity and quality, school almuerzo were unhealthy for both groups. The intervention failed to increase the frequency with which parents provided children with school almuerzo or enhance the quality of the latter.

Relationship between different levels of the Mexican food environment and dietary intake: a qualitative systematic review

Objective:

To investigate the possible associations between the food environment and dietary intake in the Mexican population.

Design:

Four databases (PubMed, PsychInfo, Web of Science and SCIelo) were used to retrieve relevant articles using an open timeframe. Articles were reviewed if they contained a systematic measure (i.e. food checklist) of the food environment (e.g. food availability) and dietary intake.

Setting:

Urban and rural communities in Mexico.

Participants:

Population-based studies of Mexican communities.

Results:

Twenty studies that assessed at least one food environment level, and at least one dietary outcome, were reviewed. Findings from these studies showed that changes in the Mexican food environment seem to be associated with higher availability of energy-dense foods. Energy-dense foods can be linked to a high consumption in household, environment and community food environments. When both nutrient-dense and energy-dense foods were present, individuals were more likely to consume foods with added sugars, fats and salt options than nutrient-dense items.

Conclusions:

The various levels of the food environment (i.e. household, school, community) exposed participants to energy-dense foods. Although nutrient-dense foods were present in all three levels, individuals were more likely to consume energy-dense food items. Not all three levels of the food environment are well represented in the urban and rural settings. Most studies on the community food environment were done in rural areas, whereas most studies on the school food environment were done in urban settings. Additional rigorously designed studies are needed to document the relationship between the food environment and dietary intake in the Mexican population.

Cross-Country Comparison of School Neighborhood Food Environments in Houston, Texas and Guadalajara, Mexico

Studies in the U.S. and Mexico have observed the clustering of food resources around schools, which may promote the use of these resources. Our study characterized and compared school neighborhood food environments in Guadalajara, Jalisco, and Houston, Texas, and examined socioeconomic disparities in food resource availability across school neighborhoods. We used the Goods and Services Inventory to document the frequency and type of resources within each school neighborhood. School neighborhoods in Guadalajara had significantly more food resources than those in Houston. We found that convenience stores and table service restaurants were the most prevalent food resources in school neighborhoods in both cities. Guadalajara school neighborhoods had a higher prevalence of supermarkets and grocery stores than Houston. Low-income school neighborhoods in Guadalajara with poorly educated residents had significantly more food carts than high-income neighborhoods with more educated residents. In Houston, we found significantly more fast food restaurants and convenience stores in school neighborhoods with more educated residents than school neighborhoods with less educated residents. The influence of food resources within school neighborhoods on the dietary habits of schoolchildren should be further explored in both the U.S. and Mexico. The characterization of school neighborhood food environments can inform policymakers, city planners, and school officials who seek to implement policies to create healthier food environments.

Nutritional Intervention to Improve the Quality of Lunchboxes Among Mexican School Children

In Mexico, the type of foods included in the lunchboxes of school children are unhealthy. The aim of this study was to evaluate the effects of an intervention program to improve the quality of the foods in the lunchboxes. Two schools were randomly selected as the intervention group (IG) and two more as the control group (CG). The evaluation was performed by comparing a food list from 3 days before and 6 months after the intervention. The components of the intervention included: exposure to posters inside and outside the classrooms and the distribution of pamphlets to parents, the pamphlets provided recipes and information about healthy foods. A lunchbox was considered adequate (AL) if it had less than 276 cal, fruits or vegetables, and an item prepared at home; a healthy lunchbox (HL) consisted of fruits or vegetables, water, and it did not have unhealthy foods. At the beginning of the study there were no significant differences in the compliance of AL and HL in both groups. By the end of the study, 19 % of the children in the IG and 10 % of the children in the CG met the criteria of a HL (p = 0.002). The results of this study demonstrate that a simple, 6 month intervention targeting parents improved the quality of the foods in the lunchboxes of second and sixth graders.

Breakfast Skipping, Anxiety, Exercise, and Soda Consumption are Associated with Diet Quality in Mexican College Students

ABSTEACT Despite the reported poor dietary habits and risk of weight gain in college students, they remain understudied in Mexico. Mexican college students are in a rapidly changing economic environment; a shift from a traditional, homemade cuisine to a diet more heavily influenced by an industrialized culture seems to be occurring, potentially affecting the quality of their dietary intake. A health and nutrition survey was conducted among 450 Mexican college students to study the relationship between sociodemographic factors and diet quality. Dietary data were used to build macro- and micronutrient scores, dichotomized as low and normal quality. Adjusted odds (OR [95% CI]) were computed to determine the probability of low dietary quality. Breakfast skipping (5.3 [1.2, 22.7]) and risk of anxiety (2.3 [1.3, 4.4]) were associated with a greater risk of low macronutrient quality, and caloric intake < 1,800 kcal (5.8 [3.5, 9.7]), breakfast skipping (3.7 [1.4, 10.3]), vigorous exercise ≤ 1 h/wk (2.6 [1.3, 5.2]), and soda consumption > 250 mL/d (2.0 [1.2, 3.3]) with low micronutrient quality.

The contribution of at-home and away-from-home food to dietary intake among 2-13-year-old Mexican children

OBJECTIVE

Away-from-home foods have been shown to have lower nutritional quality and larger portion sizes than many foods prepared at home. We aimed to describe energy and nutrient intakes among 2-13-year-old Mexican children by eating location (at home and away from home), overall, by socio-economic status (SES) and by urbanicity.

DESIGN

Dietary intake was collected via one 24 h recall in the 2012 Mexican National Health and Nutrition Survey (ENSANUT). Location was reported for each food consumed. Results were adjusted for sex, day of recall, region, weight status, SES and urbanicity.

SETTING

Mexico (nationally representative).

SUBJECTS

Children aged 2-5 years (n 1905) and 6-13 years (n 2868).

RESULTS

Children consumed the majority of daily energy at home (89% of 2-5-year-olds; 82 % of 6-13-year-olds). The most common away-from-home eating location was school (22 % of 2-5-year-olds; 43 % of 6-13-year-olds), followed by the street (14 % of 2-5-year-olds; 13 % of 6-13-year-olds). The most common foods consumed away from home were wheat/rice and corn mixed dishes, sugar-sweetened beverages, pastries/candy/desserts, milk (2-5-year-olds only) and salty snacks (6-13-year-olds). Multivariate models showed that high-SES 2-5-year-olds consumed 14 % of daily energy away from home v. 8 % among low-SES 2-5-year-olds, and high-SES 6-13-year-olds consumed 21 % of daily energy away from home v. 14 % among low-SES 6-13 year-olds. There were no differences by urban residence.

CONCLUSIONS

Among Mexican children, most foods and beverages were consumed at home. However, the percentage of foods consumed or purchased away from home increased with age and with SES.

Rural Latino caregivers' beliefs and behaviors around their children's salt consumption

BACKGROUND

Prevalence of high blood pressure has been increasing in U.S. children, with implications for long term health consequences. Sodium consumption, a modifiable risk factor for high blood pressure, is above recommended limits and increasing. Very little is known about Latino caregiver beliefs and behaviors around their children's salt consumption.

METHODS

In California's Central Valley, qualitative interviews in Spanish investigated low-income caregivers' views and understandings of their children's dietary salt consumption. Thirty individual interviews and 5 focus groups were conducted (N=61). Interview transcripts were translated and transcribed, coded and thematically analyzed.

RESULTS

Seven primary topic areas around children's salt intake and its impact on health were identified: children's favorite foods, children's dietary salt sources, superiority of home-cooked foods, salty and sweet foods, managing salt for health, developing children's tastes, and adding salt added at the table. Parents recognize common sources of sodium such as "junk food" and processed food and made efforts to limit their children's consumption of these foods, but may overlook other significant sodium sources, particularly bread, cheese, prepared soups and sports drinks. Caregivers recognize excess salt as unhealthy for children, but don't believe health problems (like high blood pressure) can occur in young children. Nevertheless, they made efforts to limit how much salt their children consumed through a variety of strategies; school meals were a source of high sodium that they felt were outside of their control.

CONCLUSION

Latino caregivers are concerned about their children's salt intake and attempt to limit consumption, but some common sources of sodium are under-recognized.