Search results

Abstract Background Noncommunicable diseases (NCD) are the most common causes of morbidity and mortality worldwide, even in low- and middle-income countries (LMIC). Recent trends in health promotion emphasize community-based interventions as an important strategy for improving health outcomes. The aim of this study was to conduct formative research regarding the perceptions of NCD risk factors, their influencing factors, and community resources available to aid the development and implementation of a community-based intervention with school-age children. Methods Focus group discussions (n = 18), home visits (n = 30), and individual semi-structured interviews (n = 26) were conducted in three urban communities in Guatemala with school-age children (10–12 years of age), teachers, parents, and local community members (i.e., school principals, school food kiosk vendors, religious leaders, authority representatives). All focus groups and interviews were transcribed verbatim for thematic analysis. Results Children, parents, and teachers have general knowledge about modifiable risk factors. Adults worried more about tobacco use, as compared to unhealthy diet and physical inactivity in children. Participants identified features at the intrapersonal (e.g., negative emotional state), interpersonal (e.g., peers as role models), and organizational and community levels (e.g., high levels of crime) that influence these risk factors in children. School committees, religious leaders, and government programs and activities were among the positive community resources identified. Conclusions These findings should help researchers in Guatemala and similar LMIC to develop community-based interventions for NCD prevention in school-age children that are effective, feasible, and culturally acceptable.

Developing countries have undergone rapid transitions driven by globalization and development, which have accelerated increases in prevalence of overweight and obesity among children. Schools have been identified as effective settings for early intervention and favorable arenas in which to target children's dietary behaviors. In Guatemala, public schools commonly have food kiosks (casetas) which provide food and drink for sale to children. From July through October 2013, observation during recess, in-depth interviews with school principals (n=4) and caseta vendors (n=4), and focus groups with children (n=48) were conducted. This paper explores products currently available to children at casetas. We found that current factors that impact what casetas offer and subsequent nutrition habits of children at school include: regulations and enforcement; vendor investment and earnings; vendor challenges related to resources (i.e. refrigeration); the current economy and product demand; product pricing; and children's product preferences. These factors influence the products that are available and children's tendency to purchase them. Potential strategies that emerged include healthy food preparation to improve product health and quality, price manipulation and promotions, raffles and games to encourage healthy product consumption, as well as government and corporate involvement to push policy toward development of healthier products.

Ultraprocessed products (UPPs), associated with obesity and non-communicable diseases (NCDs), are becoming predominant on the global market and a target for market-driven fortification initiatives. The aim of this article is to describe the implications of adding micronutrients to UPPs with excessive amounts of critical nutrients associated with NCDs and provide recommendations for legislation and policies. UPPs with added micronutrients such as breakfast cereals, sugar-sweetened beverages, powder beverages, fruit juices, sauces, and bouillon cubes, among others, are commonly available and heavily promoted in Latin American countries. Misleading advertising of UPPs with added micronutrients and with excessive content of sugar, fat, and salt might increase the consumption of such products, giving them a "health halo effect" that leads consumers to overestimate their nutritional quality and healthfulness. Although international collections of standards such as the Codex Alimentarius provide some guidelines on this matter, countries need to implement national legislations, through a food systems approach, to regulate the marketing and labeling of UPPs. Lastly, there is still the need to foster research to close knowledge gaps and help countries to guide the process of food fortification strategies from a regulatory standpoint.