Nutritional Intervention to Improve the Quality of Lunchboxes Among Mexican School Children

Abstract

In Mexico, the type of foods included in the lunchboxes of school children are unhealthy. The aim of this study was to evaluate the effects of an intervention program to improve the quality of the foods in the lunchboxes. Two schools were randomly selected as the intervention group (IG) and two more as the control group (CG). The evaluation was performed by comparing a food list from 3 days before and 6 months after the intervention. The components of the intervention included: exposure to posters inside and outside the classrooms and the distribution of pamphlets to parents, the pamphlets provided recipes and information about healthy foods. A lunchbox was considered adequate (AL) if it had less than 276 cal, fruits or vegetables, and an item prepared at home; a healthy lunchbox (HL) consisted of fruits or vegetables, water, and it did not have unhealthy foods. At the beginning of the study there were no significant differences in the compliance of AL and HL in both groups. By the end of the study, 19 % of the children in the IG and 10 % of the children in the CG met the criteria of a HL (p = 0.002). The results of this study demonstrate that a simple, 6 month intervention targeting parents improved the quality of the foods in the lunchboxes of second and sixth graders.

The effectiveness of lunchbox interventions on improving the foods and beverages packed and consumed by children at centre-based care or school: a systematic review and meta-analysis

“…A description of the included studies is shown in Table 1. Of the 10 included trials, three were conducted in the U.S., [31–33] three in U.K., [21, 34–36] two in Australia [37, 38], one in Mexico [39] and one in Israel [40]. Eight of the studies employed cluster randomised-controlled trial designs, [21, 31, 32, 34, 37–40] and two were conducted using quasi-experimental designs [24, 35]…”

“…These trials recruited samples of between 132 and 560 children with the age of participants ranging from 3 to 6 years. Of the six trials conducted in schools, [21, 31, 34, 35, 39, 40] the number of participating schools ranged from two to 89. These trials recruited samples of between 238 and 2443 students with the age of participants ranging from 4 to 14 years.…”

“…Only two interventions, both centre-based care studies, incorporated the development of a policy and the communication of this to parents [37, 38]. Seven of the studies were stand-alone lunchbox interventions [21, 24, 31, 32, 34, 35, 39] whilst three were part of a larger child obesity prevention program, two occurring in centre-based care which included strategies to support centres to deliver physical activity (e.g. manuals, training, equipment) or information to parents targeting small screen recreation reduction [37, 38] and one in schools which included 15 × 45 min physical activity delivered to children by trained professionals [40].…”

“…manuals, training, equipment) or information to parents targeting small screen recreation reduction [37, 38] and one in schools which included 15 × 45 min physical activity delivered to children by trained professionals [40]. Intervention duration across the studies ranged from five [24] to 8 weeks [39], 4 to 7 months, [31, 32, 37–40] and up to 12 months [34, 35] (see Table 1).…”

“…Follow-up data collection ranged from; 6 weeks post-baseline in one trial, [24] five to 7 months in five trials, [31, 32, 37, 39, 40] 12 months in three trials, [21, 34, 35] and 21 months in the remaining trial [38]. Of the eight studies that examined the impact of interventions on the nutritional content of foods and beverages provided from home [21, 24, 32, 34, 37] two studies reported on vegetables and fruit as a combined result, [35, 38] three reported on discretionary foods including snacks, or confectionary; [21, 37, 38] three reported on sugar-sweetened drinks; [21, 31, 37]; and three reported on the proportion of lunchboxes meeting a pre-defined category that is “adequate/ healthy” [39],“balanced/ overloaded with extras/ unbalanced” [37] or a quality score for the packed lunch [40]. One study also reported on the mean weights of sandwiches, dairy foods, and other starchy foods provided [21].…”