Front-of-pack labeling is a cost-effective strategy to decrease population consumption of sodium, sugar, saturated fat, total fat, and trans-fatty acids, considered critical nutrients for chronic disease. Our main objective was to explore the subjective understanding of labels that are currently used internationally among low- and middle-income Mexican consumers. We performed two phases of 10 focus groups with adolescents (13–15 y), young adults (21–23 y), mothers of children 3–12 y, fathers of children 3–12 y and older adults (55–70 y). Seven FOPL were evaluated: Guideline Daily Amounts, Multiple Traffic Light, Chilean Warning labels, Warning labels in Red, 5-Color Nutrition Label, Health Star Rating, and Healthy Choice label. Data was analyzed with a triangulation of researchers using a content analysis, based on three codes: 1) awareness and use of the Guideline Daily Amounts, 2) acceptability, and 3) subjective understanding of labels. Most participants were aware of the Guideline Daily Amounts, however they rarely used it because interpreting the information displayed on the label was too complicated. Health Star Rating, Warning labels, Multiple Traffic Light and the Healthy Choice logo labels were the most understandable, however the acceptability of the The Healthy Choice logo decreased as it did not provide information on specific ingredients. The Warning labels was the only label able to warn about critical nutrients that could represent a health risk. The Warning labels in red was more accepted compared to Warning labels in black. Results show that directive and semi-directive labels, such as Warning labels, Health Star Rating or Multiple Traffic Light, may be better at helping population of low- and middle income make healthier food choices, than non-directive FOPL such as the Guideline Daily Amounts implemented in México. The study results highlight the potential of Warning labels to support decreases in the consumption of critical ingredients in low- and middle-income Mexican consumers.

Objetivo. Evaluar la asociación entre el perfil nutricional y las estrategias de publicidad de alimentos procesados de trigo y maíz (APTM) ofertados en puntos de venta de la Ciudad de México. Material y métodos. Se recolectó información del contenido nutricional y tipos de publicidad para doce categorías de APTM en 58 puntos de venta localizados en zonas de niveles socioeconómicos (NSE) bajo y alto. Resultados. El 8.5 y 10.7% de APTM en NSE bajo y alto fueron saludables, respectivamente. ≤12% de los APTM fueron saludables, excepto harinas (~30%) y pastas (~95%). Entre ambos NSE, de 28.3% a 31.9% de APTM usaron personajes, de 46.5% a 50.1% promociones y de 38.2% a 41.3% claims. Se encontraron asociaciones significativas (p<0.001) en el uso de publicidad de APTM no saludables en ambas zonas de NSE. Conclusiones. La mayoría de los APTM en venta fueron no saludables, y se ofertaron más en el NSE bajo. En ambos NSE la mayoría de APTM no saludables usa estrategias publicitarias para estimular su consumo.

Summary 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.

The contributions of processed foods to the overweight and obesity problem in Latin America are well known. Engagement with the private and public sectors on possible solutions requires deeper insights into where and how these products are sold and the related implications for diet quality. This article characterizes the diversity of wheat and maize processed foods (WMPFs) available to consumers in Mexico City. Data were gathered across nine product categories at different points of sale (supermarkets, small grocery stores, convenience stores) in high and low socioeconomic (SE) areas. We assessed WMPFs based on Nutri-Score profile, price, and health and nutrition claims. Roughly 17.4% of the WMPFs were considered healthy, of which 62.2% were pastas and breads. Availability of healthy WMPFs was scarce in most stores, particularly in convenience stores Compared to supermarkets in the low SE area, those in the high SE area exhibited greater variety in access to healthy WMPFs across all product categories. In the low SE area, healthy WMPFs were priced 16–69% lower than unhealthy WMPFs across product categories. The extensive variety of unhealthy WMPFs, the limited stock of healthy WMPFs in most retail outlets, and the confusing health and nutrition claims on packaging make it difficult for urban consumers to find and choose healthy WMPFs.

Small-quantity lipid-based nutrient supplements (SQ-LNS) could help prevent malnutrition. Our primary objective was to examine the acceptability and consumption of sweetened and unsweetened versions of SQ-LNS before and after 14-days of repeated exposure. A total of 78 mother-infant dyads recruited from health centers in Morelos, Mexico, were randomized to two groups of SQ-LNS (sweetened, LNS-S; unsweetened, LNS-U). During the study, infants were fed SQ-LNS (20 g) mixed with 30 g of complementary food of the caregiver’s choice. The amount of supplement-food mixture consumed was measured before, during and after a 14-day home exposure period. We defined acceptability as consumption of at least 50% of the offered food mixture. At initial exposure, LNS-U consumption was on average 44.0% (95% CI: 31.4, 58.5) and LNS-S 34.8% (25.3, 44.0); at final exposure, LNS-U and LNS-S consumption were 38.5% (27.8, 54.0) and 31.5% (21.6, 43.0). The average change in consumption did not differ between the groups (2.2 p.p. (−17.2, 24.4)). We conclude that the acceptability of sweetened and unsweetened SQ-LNS was low in this study population. Since consumption did not differ between supplement versions, we encourage the use of the unsweetened version given the potential effects that added sugar may have on weight gain especially in regions facing the double burden of malnutrition.