Description of the food environment in elementary schools in Hermosillo, Sonora

Abstract

Introduction: In Mexico, 33.2% of school-age children are overweight or obese and the consumption of sugar-sweetened beverages and energy-dense, nutrient-poor foods is high. Justification: The school food environment is important since children spend an important part of their time at school and consume one-third to one-half of their daily meals at school. In 2014, general guidelines for the regulation of foods and beverages in schools was published, but the extent of their implementation is not known. Objective: To describe the food environment in elementary schools in Hermosillo against the 2014 AGREEMENT that regulates the sale and distribution of food and beverages in schools. Methods: Descriptive cross-sectional study in a representative, random sample of elementary schools in Hermosillo, using the INFORMAS network tools. Data collection included: a) an interview with a school authority to identify barriers or facilitators for the application of the AGREEMENT; b) a checklist of items in the school canteen; c) a checklist of the school breakfast menu; d) structural evaluation verifying availability of water and other relevant aspects. The main indicators were: percentage of implementation (self-report) of the AGREEMENT and percentage of compliance with the AGREEMENT (based on tools b and c; verified by the researchers). Results: 119 schools participated (response rate 87.5%), with 15.1% (95%CI 9.2–22.8) of the schools reporting having fully implemented the AGREEMENT. However, only 1% (95%CI 0–5.3) of the school canteens and 71.4% (95%CI 57.8–82.7) of the breakfast menus fully complied with the AGREEMENT. A variety of sugar-sweetened beverages and energy-dense, nutrient poor products were found in the school canteens. Further, only 43.7% of the water fountains in schools were functional and 23.4% were clean. Conclusions: The AGREEMENT has been poorly implemented. Actions are needed to encourage and support its full implementation to improve the food environment in Mexican schools.