Comparison of the nutrient composition of eggs produced in the Guatemalan highlands during the wet and dry seasons.

The potential of chicken eggs as a nutritionally complete protein and source of key micronutrients during the first 1000 days post-conception has been progressively recognized across the globe, particularly in resource-poor settings. Fluctuation of egg nutrient content by season is relatively unknown, which may influence international food composition databases and outcomes in intervention studies using egg supplementation. To better interpret the findings of The Saqmolo' Project, we conducted comprehensive nutrient analyses on eggs produced during the wet and dry seasons in the highlands of central Guatemala. We randomly collected 36 shell eggs from a local farm during both seasons, hard-boiled, and prepared them for transport to the United States, where they were pooled and assessed for their nutrient composition. Methods of the Association of Official Analytical Chemists, the American Oil Chemists Society, and the American Association of Cereal Chemists were utilized to determine total energy, moisture, ash, total protein, total fat, fatty acids, total carbohydrates, 12 vitamins, 11 minerals, and carotenoids, by season, in some instances with modifications. Differences in nutrient composition between de-shelled hard-boiled eggs collected between seasons were assessed using an analysis of variance (ANOVA) and Tukey's family error rate comparison test. Most nutrients in eggs produced in the highlands of central Guatemala differed negligibly (but statistically significantly) based on seasonality. Only vitamins A and E, folate, choline, and calcium fluctuated at clinically significant levels relative to the AI/RDA for infants 7-12 months. Total energy, protein, trans fatty acids, moisture, and vitamin D3 levels did not differ between seasons (p > .05). Further multi-year sampling is needed to examine how seasonal variation affects the nutrient composition of eggs. These data may be used to supplement existing national and regional food composition databases.

Engaging the Guatemala Scientific Diaspora: The Power of Networking and Shared Learning.

The underdevelopment of the higher education system in Guatemala and the fragility of its science and technology (S&T) contexts have compelled a significant number of talented Guatemalan scientists to be trained, educated, and employed abroad. The relocation of such skilled human power to different countries and regions has resulted in a growing Guatemalan Scientific Diaspora (GSD). Until recently, the emigration of scientists from the Global South to scientifically advanced countries in the North was studied as it negatively impacted the countries of origin. However, technological upgrades and globalization have progressively shifted the paradigm in which such scientific diasporas interact and connect, thus enabling them to influence their home countries positively. Due to the lack of knowledge-based evidence and functioning connecting platforms, the value and potential of the GSD in their involvement in proposing solutions to complex socio-economic, environmental, and other challenges faced by Guatemalan society remain unknown. Moreover, the lack of interaction of relevant stakeholders (S&T policy agents, international partners, higher education institutions and research centers, industry, and relevant not governmental organizations) represents a pervasive obstacle to the untapped impact of the GSD in the country. This study outlines the Guatemalan scientific diasporas' networking as a mechanism for building research excellence and intellectual capital. This force could respond to the need to strengthen the national science capacities and meet the demands for knowledge production and access to broader sectors of society. This research applied qualitative methodology that, through the conduction of focus group discussions and semi-structured interviews with members of the Guatemalan scientific community and relevant key stakeholders, delved into the existence and articulation of the GSD and potential stages for their engagement with their country of origin. Findings highlight the importance of digital and technological pathways that might leverage the GSD's knowledge and experience, channeling skills, and international connections for better interaction with the Guatemalan society. Furthermore, the discussion addresses how technology might turn brain drain into brain circulation, enabling the articulation of the GSD as a viable opportunity to generate collaboration between scientists abroad and local actors, ultimately impacting the building and development of Guatemalan science and national research capacities.

Academy of Nutrition and Dietetics Nutrition Research Network: The Saqmolo' Project Rationale and Study Protocol for a Randomized Controlled Trial Examining the Influence of Daily Complementary Feeding of Eggs on Infant Development and Growth in Guatemala.

Adequate nutrition during the complementary feeding period is critical for optimal child growth and development and for promoting long-term educational attainment and economic potential. To prioritize limited public health resources, there is a need for studies that rigorously assess the influence of multicomponent integrated nutrition interventions in children younger than age 2 years in different contexts. This study aimed to describe the rationale and protocol for the Saqmolo' Project using the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) guidelines. The Saqmolo' (ie, "egg" in the Mayan language, Kaqchiquel) Project is an individually randomized, partially blinded, controlled comparative effectiveness trial to evaluate the influence of adding delivery of a single whole egg per day to local standard nutrition care (ie, growth monitoring, medical care, deworming medication, multiple micronutrient powders for point-of-use food fortification [chispitas], and individualized complementary and responsive feeding education for caregivers) for 6 months, compared with the local standard nutrition care package alone, on child development, growth, and diet quality measures in rural indigenous Mayan infants aged 6 to 9 months at baseline (N = 1,200). The study is being executed in partnership with the Wuqu' Kawoq/Maya Health Alliance, a primary health care organization located in central Guatemala. Primary outcomes for this study are changes in global development scores, assessed using the Guide for Monitoring Global Development and the Caregiver Reported Child Development Instruments. Secondary outcomes include changes in infant hemoglobin, anthropometric measures (including z scores for weight for age, length for age, weight for length, and head circumference for age), and diet quality as measured using the World Health Organization's infant and young child feeding indicators. The results of the Saqmolo' Project may help to inform public health decision making regarding resource allocation for effective nutrition interventions during the complementary feeding period.

The Nutritional Contribution of Foods and Beverages Provided by Government-Sponsored Day Care Centers in Guatemala.

BACKGROUND: Meals served at government-run day care centers must be nutritionally adequate to ensure good health and proper development of preschool-aged children. They can provide a controlled opportunity to complement the daily diet of children in vulnerable populations. OBJECTIVE: To determine the nutrient adequacy and leading food sources of nutrients provided by the diet served in government-sponsored day care centers. METHODS: Estimated daily energy and nutrient intakes of a theoretical 40-day day care center menu were calculated, and the nutrient adequacy was assessed. Nutrient densities and critical nutrient densities of the menu were computed to identify nutrient inadequacies. Furthermore, main sources of nutrients were identified, and energy and nutrient distributions were examined by meal time. RESULTS: The menu provides approximately 90% of daily energy requirement and more than 100% of Recommended Nutrient Intakes (RNIs), with the exception of vitamin D and calcium. Sugar was the first leading source of energy, whereas milk was the first leading contributor of vitamin D. CONCLUSION: Within an environment of budgetary constraints, the Guatemalan government developed and advocated an exemplary menu offering for children in the vulnerable preschool period. We have demonstrated that, if prepared and served as planned, the items from the official, standard menu would supply most of the nutrients needed. High vitamin A intake related to the mandated national fortification program is a potential problem. From the analysis, it was found that vitamin D emerges as the most prominent candidate for a problem nutrient of deficient intake.

Dietary ratio of animal:plant protein is associated with 24-h urinary iodine excretion in healthy school children.

UNLABELLED: Adequate dietary iodine intake in children is essential for optimal physical and neurological development. Whether lower dietary animal food and salt intake may adversely affect iodine status is under discussion. We examined the association between dietary animal:plant protein ratio with 24-h urinary iodine excretion (24-h UI, µg/d), and whether this is modified by salt intake. A 24-h UI was measured in 1959 24-h urine samples from 516 6- to 12-year-old participants of the Dortmund Nutritional and Anthropometric Longitudinally Designed Study. Parallel 3 d weighed food records were used to estimate dietary intakes. Protein sources were classified as dairy, animal and plant. A repeated-measures regression model (PROC MIXED) was used to analyse the effect of animal:plant protein ratios on 24-h UI. ANIMAL: plant protein ratios ranged from 0.5 (95 % CI 0.4, 0.6) to 1.6 (95 % CI 1.4, 1.9) (lowest and highest quartile). After adjustment for total energy intake, main dietary iodine sources (dairy and salt intake), and further covariates, the inter-individual variation in animal:plant protein ratio was significantly associated with variation in 24-h UI. One unit higher animal:plant protein ratio predicted 6 µg/d higher 24-h UI (P= 0.002) in boys and 5 µg/d (P= 0.03) in girls. This relationship was partially mediated by a higher salt intake at higher animal:plant protein ratios. These results suggest that lower consumption of animal protein is associated with a small decline in iodine excretion, partially mediated by decreased salt intake. Because limited salt and increased intake of plant-based foods are part of a preferable healthy food pattern, effective nutrition political strategies will be required in the future to ensure appropriate iodine nutrition in adherent populations.

Iodine status assessment in children: spot urine iodine concentration reasonably reflects true twenty-four-hour iodine excretion only when scaled to creatinine.

BACKGROUND: Currently, the measurement of urinary iodine concentration (UIC, µg/L) is the recommended parameter to assess iodine status, however, the dependency of UIC on urine volume may limit its use as an accurate parameter for monitoring iodine status in populations. Therefore, our objective was to compare two approaches for the assessment of urinary iodine excretion in spot urine samples: UIC (µg/L) and a creatinine-scaled estimate of 24-hour iodine excretion (est24h-UIEcrea [µg/d]) against actually measured 24-hour urinary iodine excretion rates (24h-UIE, µg/d). METHODS: Urinary iodine and creatinine were measured both in 24-hour urine samples and parallel collected spot urine samples from 180 healthy participants of the DONALD Study, aged 6-18 years. 24h-UIE was used as quasi-reference for actual iodine status. Published 24-hour creatinine reference values served to calculate est24h-UIEcrea. Correlation analysis, cross-classifications, and Bland-Altman plots were used to evaluate agreement between the different assessment approaches. RESULTS: Correlation coefficients of 24h-UIE with UIC (r=0.12, r=0.22; p=n.s.) were substantially weaker than with est24h-UIEcrea (r=0.41, r=0.47; p<0.001) in the 6-12 year old and 13-18 year old groups, respectively. Cross-classification into opposite quartiles by UIC was 7% (6-12 year old group) and 15% (13-18 year old group) versus 5% and 3% by est24h-UIEcrea, respectively. Bland-Altman plots indicated greater deviation from 24h-UIE for the UIC versus the est24h-UIEcrea approach. CONCLUSION: Our findings in children and adolescents clearly show a better comparability of real 24h-UIE with est24h-UIEcrea than with UIC. Whenever highest possible validity is required for iodine status assessment from spot urine sampling, the determination of est24h-UIEcrea appears to be the more accurate monitoring approach.

Long-term urine biobanking: storage stability of clinical chemical parameters under moderate freezing conditions without use of preservatives.

OBJECTIVE: To examine the long-term stability and validity of analyte concentrations of 21 clinical biochemistry parameters in 24-h urine samples stored for 12 or 15 yr at -22°C and preservative free. DESIGN AND METHODS: Healthy children's 24-h urine samples in which the respective analytes had been measured shortly after sample collection (baseline) were reanalyzed. Second measurement was performed after 12 yr (organic acids) and 15 yr (creatinine, urea, osmolality, iodine, nitrogen, anions, cations, acid-base parameters) with the same analytical methodology. Paired comparisons and correlations between the baseline and repeated measurements were done. Recovery rates were calculated. RESULTS: More than half of the analytes (creatinine, urea, iodine, nitrogen, sodium, potassium, magnesium, calcium, ammonium, bicarbonate, citric & uric acid) showed measurement values after >10 yr of storage not significantly different from baseline. 15 of the 21 parameters were highly correlated (r=0.99) between baseline and second measurement. Poorest correlation was r=0.77 for oxalate. Recovery ranged from 73% (oxalate) to 105% (phosphate). CONCLUSION: Our results suggest high long-term stability and measurement validity for numerous clinical chemistry parameters stored at -22°C without addition of any urine preservative. Prospective storage of urine aliquots at -22°C for periods even exceeding 10 yr, appears to be an acceptable and valid tool in epidemiological settings for later quantification of several urine analytes.

Estimates of exclusive breastfeeding rates among mother-infant dyads in Quetzaltenango, Guatemala, vary according to interview method and time frame.

BACKGROUND: The World Health Organization (WHO) recommends exclusive breastfeeding, defined as receiving only breastmilk, through the first 6 months of life to optimize survival, health, and development. OBJECTIVE: To assess exclusive and predominant breastfeeding rates, as defined by WHO, in a sample of Guatemalan infants using three dietary assessment methods. METHODS: Mothers of 156 infants (78 boys and 78 girls) in the 6th month of life, attending a public health center in Quetzaltenango, an urban area located in the Highlands of Guatemala, were recruited. A single face-to-face interview was performed to assess infant dietary intake using three methods: previous day dietary recall (as suggested by WHO), current feeding practices, and recall of feeding practices since birth. RESULTS: Based on the previous day dietary recall method, exclusive breastfeeding was reported by 87 (56%) of the mothers. Exclusive breastfeeding rates were much lower when estimated by current feeding practices questions (20%) and even lower when based on recall of feeding practices since birth (9%). The sum of exclusive and predominant breastfeeding (full breastfeeding) rates was 58%, 49%, and 31% based on previous day dietary recall, current feeding practices, and recall of feeding practices since birth, respectively. CONCLUSIONS: The WHO method of dietary assessment, based solely on the previous day dietary recall, overestimates the exclusive breastfeeding rate compared with recall of feeding practices since birth. In our population sample, adherence to the WHO guidelines for feeding in the first semester of infancy was less than ideal and in need of strengthening.

Prevalence of giardiasis in children attending semi-urban daycare centres in Guatemala and comparison of 3 giardia detection tests.

Giardia intestinalis is an intestinal parasite widely prevalent in children attending daycare centres worldwide and has been associated with undernutrition. Stool samples from 48 Guatemalan children (aged 1.5-7 years) attending participating daycare centres were analyzed over five weeks for presence of Giardia intestinalis using light microscopy, ELISA, and rapid dipstick test. Giardia prevalence rates were 43.7% at Week 0 and 44.7% at Week 4, based on ELISA. Intensity, but not prevalence, of infection showed a trend toward decreased weight-for-age (1-tailed p = 0.08). We believe that ELISA analysis of stool samples may be further adapted for measuring the intensity of infection in humans.

Contribution of fruit and vegetable intake to hydration status in schoolchildren.

BACKGROUND: The specific effects of fruit and vegetable (F&V) intake on water balance and consequently on 24-h hydration status (HS) are unknown. OBJECTIVES: In a large observational cohort of German children, we examined whether a higher F&V intake per se is associated with improved HS and attempted to quantify the influence of greater consumption of F&Vs on HS. DESIGN: A total of 1286 complete 3-d weighed dietary records and 24-h urine samples for 442 children (4- to 10-y-olds) collected in 2000-2010 in the Dortmund Nutritional and Anthropometric Longitudinally Designed Study were analyzed. Free water reserve [FWR; urine volume (mL/24 h) minus obligatory urine volume (mL/24 h)] served as an HS biomarker. Median FWR and water balance variables were analyzed in different categories of solid-F&V intakes. Repeated-measures regression models (PROC MIXED; SAS Institute), adjusted for all other dietary water sources, were used to quantify the separate effects of solid-F&V and F&V-juice consumption on FWR. RESULTS: Negative FWR values, which indicated risk of hypohydration, were observed in 22% of children. FWR was significantly higher in solid-F&V consumers with high intakes than in those with low intakes (P < 0.0001). PROC MIXED models predicted an increase of 46 mL in FWR (average in boys and girls) when increasing solid-F&V intake by 100 g. Similar results were observed for F&V juice (ß = 43, P < 0.0001). Drinking water and milk were the other significant dietary predictors of FWR. Solid F&Vs and F&V juices contributed 12% and 10%, respectively, to total water intake. CONCLUSIONS: These data confirm that regular intake of F&Vs may relevantly improve HS in children. Dietary interventions to increase F&V intake may be a promising strategy to achieve positive water balance in this population.

Validity and correspondence of non-invasively determined hemoglobin concentrations by two trans-cutaneous digital measuring devices.

Hemoglobin (Hb) concentration is the central diagnostic indicator for anemia, including nutritional anemia. The objective of this study was to compare the Hb values determined by two portable, non-invasive devices across a wide Hb spectrum against formal laboratory measurements, and with each other. Eighty Guatemalan adults (40 highland men, 40 lowland pregnant women) provided venous blood for formal Hb colorimetric determination. Hb was also registered sequentially on the Rad-87™ pulse CO-Oximeter with Rainbow Set technology (Masimo) and Haemospect® (MBR Optical Systems) by non-invasive skin-probe contact procedures as per manufacturers' instructions. Whole blood Hb concentrations ranged from 7.8 to 18.5 g/dL (mean, 12.9±2.3 g/dL and median, 13.3 g/dL). Corresponding descriptive statistics were: range, 9.6 to 16.2 g/dL; mean, 12.1±1.5 g/dL; and median, 11.9 g/L, respectively, with the Rad-87™ (nail bed). They were: range, 8.7 to 15.8 g/dL; mean, 12.7±1.8 g/dL; and median13.0 g/dL for the Hemospect® for forearm contact. They were: range, 9.1 to 17.5 g/dL; mean, 13.2±2.1 g/dL; and median, 13.4 g/dL for palm contact. The Pearson correlation coefficient of venous blood Hb with the former device's Hb values was r=0.59 (p<0.001), and r=0.94 (p<0.001) and r=0.90 (p<0.001) with those of the latter device at the palm and forearm, respectively. The inter-site Lin coefficient was r=0.84. Sensitivity and specificity were variable across devices, depending on Hb cut-off and measurement procedures. With Hb cut-off values of <12.0 g/dL for adult (non-pregnant women and <13.0 g/dL for adult men), the Haemospect device's performance here would provide adequate potential for screening purposes.

Beverage consumption and anthropometric outcomes among schoolchildren in Guatemala.

This analysis explores the clustering of beverage patterns in a single day in private vs. public school children in urban Guatemala. This study is based on measurements taken from 356 third- and fourth-grade pupils from the highland city of Quetzaltenango. Height, weight and body mass index were assessed, and one day's intake of all foods and beverages using a pictorial workbook and dietician assisted recall. Mean differences in beverage consumption were compared for private vs. public school children and by anthropometric outcomes (stunting, overweight and obesity). Plain water was consumed by 30.9% of the children on the day intakes were measured, with higher proportions of water drinkers among private school children. Children having reported water intake on that day consumed 154 fewer kcal (-7.7%) compared with the energy intake of children not having reported water intake (P = 0.02). Significantly more children of high socio-economic status (SES) consumed dairy, fruit juice, commercial fruit juice, fruit drink and soda whereas low SES children consumed thin gruels and infusions. A key result from this study is the finding of a lower energy intake shown by children reporting water intake.

Older Mayan residents of the western highlands of Guatemala lack sufficient levels of vitamin D.

Vitamin D (VitD) levels in older Mayans are currently unknown. Geographic factors, for example, residences in areas receiving ample sunlight at high altitudes and latitudes near the equator, would favor optimum VitD levels, whereas demographic factors, for example, darker skin pigmentation, clothing practices, and older age, would favor low 25-hydroxy-vitamin D, or 25(OH)D, levels. Conjecturing that demographic factors affecting VitD status might outweigh geographic factors in this population, we hypothesized that older Mayans have suboptimal values of 25(OH)D. We also hypothesized that older Mayans in rural areas would have higher VitD levels than would their urban counterparts. Blood samples were collected from 108 healthy older Mayans (mean age, 69 years) from urban (n = 84, 50% male) and rural settings (n = 24, 50% male) during the summer of 2008 in the highlands of Quetzaltenango, Guatemala. We assessed 25(OH)D concentrations by radioimmunoassay in a US-based laboratory. Mean (SD) serum 25(OH)D values were 53.3 (15.0) nmol/L, and lower 25(OH)D values were associated with increasing age (r = -0.58, P = .004). Of all subjects, 3.7% (n = 4) maintained an optimal status of 25(OH)D (>80 nmol/L), 50% (n = 54) had values between 50 and 80 nmol/L, and 46.3% (n = 50) had levels less than 50 nmol/L. Urban subjects had nonsignificantly higher 25(OH)D values (55.0 ± 15.3 nmol/L) than did rural subjects (47.4 ± 12.4 nmol/L, P = .228). Men had significantly higher values (58.2 ± 16.5 nmol/L) than did women (48.4 ± 11.6 nmol/L, P = .001). We conclude that despite residing in an optimal geographic location to receive adequate sunlight exposure, most older Guatemalan Mayans in Quetzaltenango have suboptimal levels of VitD.

Concordance with selected population recommendations for cancer prevention among third- and fourth-grade schoolchildren in Quetzaltenango, Guatemala.

BACKGROUND: The World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) 1997 recommendations for cancer prevention were meant to apply to children as well as adults. OBJECTIVE: To assess the concordance of behaviors and body composition of urban Guatemalan schoolchildren with the tenets of the WCRF/AICR 1997 recommendations. METHODS: A survey was conducted involving determination of 24-hour consumption of foods and beverages by a pictorial registry and height and weight measurements in 355 third- and fourth-grade schoolchildren in the western highland city of Quetzaltenango, Guatemala. Based on a previous, exhaustive parsing of the population goal recommendations of the WCRF/AICR 1997 report, 25 subcomponents were identified. Eleven could be evaluated with the survey data collected. Adult population criteria could be applied in seven, whereas four components had unique criteria adapted to this juvenile survey setting. RESULTS: The study sample was concordant on seven components-nutrient adequacy, total variety of foods consumed, plant-based diets, body mass index, vegetable and fruit intake, limitation of red meat consumption, and limitation of total fat consumption, and nonconcordant on four-variety of fruits and vegetables consumed, variety of starchy foods consumed, total intake of starchy foods, and limitation of sugar consumption. CONCLUSIONS: Educational and public health actions need to be conceived and implemented to further improve the rate of concordance of these 11 components with the WCRF/AICR 1997 recommendations for cancer prevention.

Contribution of beverages to energy, macronutrient and micronutrient intake of third- and fourth-grade schoolchildren in Quetzaltenango, Guatemala.

Beverages are selected based on availability, culture, taste preference, health, safety and social context. Beverages may be important to energy and to the macronutrient and micronutrient quality of overall intake. The aim of this study was to determine the contribution of beverages to the dietary energy and estimated macro- and micronutrient intake to the diet of young schoolchildren. We analyzed data from third- and fourth-grade urban Guatemalan school-children aged predominantly 8-10 years old. One-day pictorial registries of all beverages, foods and snacks consumed over a 24-h period were collected from children from private (n = 219) and public (n = 230) schools. Food composition nutrient values were assigned to the items consumed. Eleven main categories of beverages were identified. The contribution of each of the 11 beverage categories to energy, macro- and micronutrients was evaluated. The estimated intake of beverages was 475,300 mL, as reported by the 449 children. As a group, the beverage consumed in the greatest quantity was coffee (126,500 mL), followed by plain water (62,000 mL). Beverages represented a mean energy contribution of 418 +/- 26 kcal (21.5% of total dietary energy). The beverages varied in energy density from 0 (water) to 1.5 kcal mL(-1) (thin gruels). Beverages contributed one-third of the dietary carbohydrate. Through the contribution of fortified drinks, beverages were important sources of vitamin A (55%), vitamin C (38%), zinc (21%) and calcium (19%). Milk was an important source for vitamin D (10%). These results show the importance of drinks to nutrition and the balance of concerns of overweight/obesity with micronutrient quality.

Dietary intakes and food sources of fat and fatty acids in Guatemalan schoolchildren: a cross-sectional study.

BACKGROUND: Consumption of healthy diets that contribute with adequate amounts of fat and fatty acids is needed for children. Among Guatemalan children, there is little information about fat intakes. Therefore, the present study sought to assess intakes of dietary fats and examine food sources of those fats in Guatemalan children. METHODS: The study subjects consisted of a convenience sample of 449 third- and fourth-grade schoolchildren (8-10 y), attending public or private schools in Quetzaltenango City, Guatemala. Dietary data was obtained by means of a single pictorial 24-h record. RESULTS: The percentages of total energy (%E) from total fat, saturated fat (SFA) and monounsaturated fat (MUFA) reached 29%E for total fat and 10%E for each SFA and MUFA, without gender differences. %E from fats in high vs. low-socio economic status (SES) children were significantly higher for boys, but not for girls, for total fat (p = 0.002) and SFA (p < 0.001). Large proportions of the children had low levels of intakes of some fatty acids (FA), particularly for n-3 FA, with >97% of all groups consuming less than 1%E from this fats. Fried eggs, sweet rolls, whole milk and cheese were main sources of total fat and, SFA. Whole milk and sweet bread were important sources of n-3 FA for high- and low-SES boys and girls, respectively. Fried plantain was the main source of n-3 FA for girls in the high-SES group. Fried fish, seafood soup, and shrimp, consumed only by boys in low amounts, were sources of eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids, which may explain the low intakes of these nutrients. CONCLUSIONS: alpha-linolenic acid, EPA and DHA were the most limiting fatty acids in diets of Guatemalan schoolchildren, which could be partially explained by the low consumption of sources of these nutrients, particularly fish and seafood (for EPA and DHA). This population will benefit from a higher consumption of culturally acceptable foods that are rich in these limiting nutrients.

Volume, frequency and participation in plain drinking water consumption by third and fourth-grade schoolchildren in Quetzaltenango, Guatemala.

Water intake was described and quantified in samples of urban Guatemalan schoolchildren stratified by gender and socio-economic status. The frequency of consumption and quantity of plain water drinking was estimated from one-day pictorial registries of all beverages, foods and snacks consumed over a 24-h period collected from 449 3rd and 4th graders from two social classes: 230 from higher SES and 219 from lower SES. Plain water was reported by 28.1% of participants on the day of registry. Quantities consumed ranged from 250 to 2250 ml. For the 449 one-day intake records, a cumulative total of 62,000 mL of water consumption was reported. This constitutes an average of 138+/-289 ml across all participants but, when divided by for water consumers only, the mean is 492+/-352 ml. Given the relatively low percentage of children consuming water, more attention is needed to ensure freely available, safe, drinking water in the school environment.

Ready-to-eat cereals are key sources of selected micronutrients among schoolchildren from public and private elementary schools in Quetzaltenango, Guatemala.

This cross-sectional dietary survey aimed to assess the consumption and relative nutrient contribution of ready-to-eat cereals (RTEC) among schoolchildren from 2 social classes in an urban center in the Guatemalan province of Quetzaltenango. A total of 449 24-hour dietary records were collected using a pictorial workbook registry method among third- and fourth-grade schoolchildren. The sample population was divided between low-income, public school attendants (n = 219) and students from higher-income private institutions (n = 230). We described the contribution of RTEC to estimated total energy; carbohydrates; protein; fat; vitamins A, C, and D; thiamin; riboflavin; folate; calcium; iron; and zinc over the 24-hour interval of registry. Approximately 41% of the subjects mentioned RTEC at least once in their 24-hour record; 93% of these at breakfast time. From the 7 RTEC varieties reported, 4 were presweetened. Estimated cereal consumption was significantly higher among private school participants (P < .001). The RTEC contributed 2.4% of estimated total energy across the whole sample and 3.6% of total carbohydrate; iron intake from RTEC was 21% of total, whereas less than 1% of calcium intake came from this source. Among the subgroup of cereal consumers, RTEC accounted for more than 40% of their daily recommendation intake for iron, vitamin C, thiamin, and riboflavin. The RTEC consumers had significantly higher intakes for all nutrients except carbohydrate and riboflavin as compared with nonconsumers. This study demonstrates the importance of RTEC as a key source of several selected micronutrients to schoolchildren's diet in this setting.

Fruit and vegetable intake of schoolchildren in Quetzaltenango, Guatemala.

OBJECTIVE: To determine if fruit and vegetable consumption among high- and low-socioeconomic status (HSES-LSES) urban schoolchildren in Quetzaltenango, Guatemala, was adequate according to World Health Organization (WHO) recommendations. METHODS: Cross-sectional data from 449 third- and fourth-grade girls and boys from 12 elementary schools were collected, analyzed, and presented by socioeconomic status and gender. Public schoolchildren were classified as LSES (n = 219) and private schoolchildren were classified as HSES (n = 230). Dietary fruit/vegetable intake of each student was determined based on a 24-hour recall pictorial record and personal interview. All food items containing fruits or vegetables (including beverages) were classified and tabulated. Frequency of fruit/vegetable intake was calculated based on "mentions" (number of times a fruit or vegetable item was reportedly consumed), and nutritional adequacy was assessed for each group by mean and median values and compared to WHO daily recommended fruit/vegetable intake (400 g). Based on World Cancer Research Fund (WCRF) exclusion guidelines, the fruit/vegetable contribution to total energy was estimated. RESULTS: Of the 247 different food items identified, 93 (37.7%) contained a fruit or vegetable. Total food mentions (n = 6 512) included 637 fruit items and 701 vegetable items. Although mean fruit/vegetable intake in grams was 461.3 (standard deviation, +/- 332.5), more than half (56.3%) of the subjects fell below the 400-g recommended daily level. Estimated fruit/vegetable contribution to total energy was 21.2% for HSES and 19.1% for LSES. CONCLUSION: This study revealed inadequate fruit/vegetable intake among the study sample. For compliance with global recommendations, interventions promoting fruit/vegetable intake are needed.

Fruit and vegetable intake of schoolchildren in Quetzaltenango, Guatemala / Consumo de frutas y vegetales en escolares de Quetzaltenango, Guatemala

Objective. To determine if fruit and vegetable consumption among high– and low–socioeconomic status (HSES–LSES) urban schoolchildren in Quetzaltenango, Guatemala, was adequate according to World Health Organization (WHO) recommendations.Methods. Cross-sectional data from 449 third- and fourth-grade girls and boys from 12 elementary schools were collected, analyzed, and presented by socioeconomic status and gender. Public schoolchildren were classified as LSES (n = 219) and private schoolchildren were classified as HSES (n = 230). Dietary fruit/vegetable intake of each student was determined based on a 24-hour recall pictorial record and personal interview. All food items containing fruits or vegetables (including beverages) were classified and tabulated. Frequency of fruit/vegetableintake was calculated based on “mentions” (number of times a fruit or vegetable item was reportedly consumed), and nutritional adequacy was assessed for each group by mean and median values and compared to WHO daily recommended fruit/vegetable intake (400 g). Based on World Cancer Research Fund (WCRF) exclusion guidelines, the fruit/vegetable contribution to total energy was estimated. Results. Of the 247 different food items identified, 93 (37.7%) contained a fruit or vegetable. Total food mentions (n = 6 512) included 637 fruit items and 701 vegetable items. Althoughmean fruit/vegetable intake in grams was 461.3 (standard deviation, ± 332.5), more than half (56.3%) of the subjects fell below the 400-g recommended daily level. Estimatedfruit/vegetable contribution to total energy was 21.2% for HSES and 19.1% for LSES. Conclusion. This study revealed inadequate fruit/vegetable intake among the study sample. For compliance with global recommendations, interventions promoting fruit/ vegetable intake are needed.

Objetivo. Determinar si el consumo de frutas y vegetales en escolares de ingresos altos y bajos de zonas urbanas de Quetzaltenango es el adecuado según las recomendaciones de la Organización Mundial de la Salud (OMS). Métodos. Estudio transversal en 449 niñas y niños de tercer y cuarto grados de 12 escuelas de educación elemental. Los datos se presentaron según el sexo y el nivel socioeconómico. Los niños de escuelas públicas (n = 219) se consideraron de nivel socioeconómicobajo (NSEB) y los de escuelas privadas (n = 230) como de nivel socioeconómicoalto (NSEA). El consumo de frutas y vegetales en la dieta de cada estudiantese determinó a partir de un recordatorio de 24 horas mediante registros pictóricos y entrevistas personales. Se tabularon todos los alimentos que contenían frutas o vegetales (incluidas las bebidas). La frecuencia del consumo de frutas y vegetales se calculó a partir de las veces que se mencionó el consumo de una fruta o un vegetal y se evaluó el grado de adecuación nutricional mediante la comparación de los valores medios y medianos de cada grupo con el consumo diario recomendado por la OMS (400 g). Se utilizaron las directivas de exclusión del Fondo Mundial para las Investigacionescontra el Cáncer (WCRF) para estimar la contribución de las frutas y vegetalesal aporte energético total. Resultados. De los 247 diferentes alimentos identificados, 93 (37,7%) contenían unafruta o un vegetal. Del los 6 512 registros, 637 contenían alguna fruta y 701 algún vegetal. Aunque el consumo medio de frutas y vegetales fue de 461,3 g (desviación estándar = ± 332,5 g), más de la mitad (56,3%) de los estudiantes tenían un consumo pordebajo de los 400 g diarios recomendados. Se estimó que las frutas y vegetales contribuían en 21,2% al aporte energético total en los niños de NSEA y en 19,1% en los de NSEB.Conclusiones. Estos resultados demuestran el inadecuado consumo de frutas y vegetales en la muestra estudiada...