Pehlke Elisa L, Letona Paola, Hurley Kristen, Gittelsohn Joel
INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Calzada Roosevelt 6-25 Zona 11, Apartado Postal 1188, Guatemala 01011, Guatemala Department of International Health, Human Nutrition Division, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe St., Baltimore, MD, USA
INCAP Research Center for the Prevention of Chronic Diseases (CIIPEC), Institute of Nutrition of Central America and Panama (INCAP), Calzada Roosevelt 6-25 Zona 11, Apartado Postal 1188, Guatemala 01011, Guatemala.
Health Promot Int. 2016 Sep;31(3):542-50. doi: 10.1093/heapro/dav011. Epub 2015 Mar 29.
Guatemala suffers the double burden of malnutrition with high rates of stunting alongside increasing childhood overweight/obesity. This study examines the school food environment (SFE) at low-income Guatemalan elementary schools and discusses its potential impact on undernutrition and overweight/obesity. From July through October 2013, direct observations, in-depth interviews with school principals (n = 4) and food kiosk vendors (n = 4, 2 interviews each) and also focus groups (FGs) with children (n = 48, 8 FGs) were conducted. The SFE comprises food from school food kiosks (casetas); food from home or purchased in the street; and food provided by the school (refacción). School casetas, street vendors and children's parents largely provide sandwiches, calorie-rich snacks and sugar-sweetened beverages. Refacción typically serves energy dense atol, a traditional beverage. The current school food program (refacción), the overall SFE and the roles/opinions of vendors and principals reveal persistent anxiety concerning undernutrition and insufficient concern for overweight/obesity. Predominant concern for elementary schoolchildren remains focused on undernutrition. However, by the time children reach elementary school (ages 6-12+), food environments should encourage dietary behaviors to prevent childhood overweight/obesity.
危地马拉面临营养不良的双重负担，发育迟缓率很高，同时儿童超重/肥胖现象也在增加。本研究调查了危地马拉低收入小学的学校食物环境（SFE），并讨论了其对营养不良和超重/肥胖的潜在影响。2013年7月至10月，进行了直接观察、对4名校长和4名食品亭摊贩（每人进行2次访谈）的深入访谈以及与48名儿童（8个焦点小组）的焦点小组讨论。学校食物环境包括学校食品亭（casetas）的食物、家里带来或在街上购买的食物以及学校提供的食物（refacción）。学校食品亭、街头小贩和儿童家长主要提供三明治、高热量零食和含糖饮料。Refacción通常提供能量密集的阿托尔，一种传统饮料。当前的学校食物计划（refacción）、整体学校食物环境以及摊贩和校长的角色/意见显示出对营养不良的持续担忧，而对超重/肥胖的关注不足。对小学生的主要担忧仍然集中在营养不良上。然而，到儿童进入小学时（6至12岁以上），食物环境应鼓励形成预防儿童超重/肥胖的饮食行为。
