Share of food group expenditure in Mexican households according to the gender of the head of household and size of the locality.

OBJECTIVE: To evaluate differences in the percentage of expenditure on food groups in Mexican households according to the gender of the household head and the size of the locality. DESIGN: Analysis of secondary data from the National Household Income and Expenditure Survey (ENIGH) 2018. We estimated the percentage of expenditure on fifteen food groups according to the gender of the head of household and locality size and evaluated the differences using a two-part model approach. SETTING: Mexico, 2018. PARTICIPANTS: A nationally representative sample of 74 647 Mexican households. RESULTS: Female-headed households allocated a lower share of expenditure to the purchase of sweetened beverages and alcoholic beverages and higher percentages to milk and dairy, fruits and water. In comparison with metropolitan households, households in rural and urban localities spent more on cereals and tubers, sugar and honey, oil and fat and less on food away from home. CONCLUSIONS: Households allocate different percentages of expenditure to diverse food groups according to the gender of the head of the household and the size of the locality where they are located. Future research should focus on understanding the economic and social disparities related to differences in food expenditure, including the gender perspective.

Prevalencia de comportamientos del movimiento en población mexicana.

OBJETIVO: Describir la prevalencia de los comportamientos del movimiento (CM) en 24 horas en población mexicana. Material y métodos. Se recolectó información de actividad física (AF), tiempo sedentario y sueño para individuos de 10 a 78 años por medio de la Encuesta Nacional de Salud y Nutrición 2022 (Ensanut 2022). RESULTADOS: Más de 65% de niños y niñas no cumple con las recomendaciones de AF y pasan >2 horas/día frente a pantallas. Casi 91% de los adolescentes pasan >2 horas/día frente a pantalla. Más de 30% de los adolescentes y adultos no cumple con las recomendaciones de sueño. Sólo 1.5% de niños y niñas, 4.7% de adolescentes, 4.0% de los adultos y 1.5% de adultos mayores cumplieron las recomendaciones de los tres CM. Conclusión. Se evidencia la necesidad de desarrollar estrategias para contrarrestar la inactividad física, el comportamiento sedentario y el sueño insuficiente desde temprana edad hasta la adultez en población mexicana.

Objective understanding of front of pack warning labels among Mexican children of public elementary schools. A randomized experiment.

BACKGROUND: Warning Labels (WL) highlight excessive amounts of critical nutrients in order to discourage consumption of unhealthful packaged food products. This study aimed to evaluate among Mexican school children, the objective understanding of traditional and numeric WL (aimed at small products) considered by the Mexican regulation, and whether cartoon characters influenced the understanding of WL. We also tested some communication strategies to facilitate the correct use of the WL. METHODS: We carried out a randomized experiment in July 2019 in public elementary schools from Morelos, Mexico. Participants aged 6-13 years, were randomly assigned to one of four groups: 1) Nutrient Facts Panel (NF) (n = 120), 2) Nutrient Facts Panel with cartoon characters (NF + C) (n = 83), considered the control groups, 3) Warning Labels (WL) (n = 109), and 4) Warning Labels with cartoon characters (WL + C) (n = 96). After allocation, children assigned to both WL groups (WL or WL + C), were randomly required to watch two posters simultaneously or a video explaining how to correctly interpret WLs. Logistic regression models adjusted by sex, age and cluster (school) were fitted. RESULTS: The percentage of children correctly choosing the healthiest or the unhealthiest option was higher for WL groups (56.8, 95%CI; 40.8-72.8) compared to NF groups (24.3, 95%CI; 20.4-28.3, p < 0.05). The understanding of traditional WL was higher (28.7, 95%CI: 22.8-35.4) than the numeric WL (19, 95%CI: 14.2-25.0, p < 0.05). But, correct answers for identifying healthy and unhealthy products were higher for numeric WL than for NF groups. Cartoon characters reduced the percentage of correct answers for choosing unhealthiest products (WL + C: 48.9, 95%CI: 25.6-72.4 vs WL: 58.7, 95%CI: 36.4-81.1, p < 0.05). The video was 2.23 times more helpful than the posters to the correct interpretation of the WL (p < 0.05). CONCLUSIONS: In scholar Mexican children, traditional and numeric WL were useful to identify healthier and unhealthier packaged products in comparison to NF, suggesting that both WL formats may effectively communicate the excessive content of nutrients of concern among children. Cartoon characters may reduce the objective understanding of the WL, underscoring the need to regulate advertising directed to children along with the implementation of front-of-pack labeling.

Comprehensive evaluation of Salud Escolar a health school program in Mexico: Rationale, design and methods.

The prevalence of obesity and overweight in Mexican children and adolescents is high (greater than 30%) and lifestyle behaviors are far from achieving health recommendations. Salud Escolar is a complex cross-sectoral multi-level policy-based program in Mexico aiming to support schoolchildren healthy behaviors. We describe the rationale, design and methods for the comprehensive evaluation of Salud Escolar during its first phase of implementation. Using a mixed-methods approach and the logic model of Salud Escolar as a guide, a comprehensive evaluation involving 3 types of evaluations was designed: 1) A design evaluation before program implementation, to determine the consistency between the design of Salud Escolar and the problem to be addressed (i.e., childhood obesity), 2) An implementation evaluation to assess potential execution bottlenecks, and 3) An outcomes evaluation, to measure short-term (i.e., knowledge, attitudes and practices related to healthy eating, drinking plain water and doing regular physical activity) and intermediate outcomes (i.e., fruit and vegetable intake, water consumption and daily moderate to vigorous physical activity). This evaluation will provide essential knowledge about program design and implementation processes, which are vital for drawing robust conclusions about the effectiveness of the program. Results and lessons learned from this comprehensive evaluation will provide evidence to improve Salud Escolar program and facilitate its upscaling process and may provide relevant information for school-based programs in other places sharing socio-contextual conditions.

Implementation of physical education policies in elementary and middle schools in Mexico.

School-based physical education (PE) is part of a whole-of-school approach to promote physical activity and its benefits for health. However, there are important gaps between the design and implementation of PE policies. This study aimed to describe the implementation fidelity and feasibility of school-based PE policies in Mexico. Data on implementation fidelity and feasibility was collected using semi-structured interviews (n = 17) and focus groups (n = 11) with high- (n = 7) and local-level (n = 122) stakeholders. We conducted a qualitative and triangulation content analysis. Feedback sessions were carried out with some participants. Barriers for implementation fidelity and feasibility of PE policies included inconsistencies in the time allocated to PE across schools and regions in the country; inconsistencies between teachers' planning of PE classes and the actual class; a wide diversity of professional profiles among PE teachers; a limited number of PE professors, materials and facilities. To address these situations, some PE teachers were able to modify lesson plans and to design PE materials made from recycled materials. In conclusion, the current way in which school-based PE policies are being implemented in Mexico hinder PE from playing a major role in promoting physical activity among children and adolescents.