OBESITY PREVENTION IN RURAL COMMUNITIES OF GUATEMALA. EXPERIENCES OF THE UNDERGRADUATE NUTRITION PROGRAM OF MARIANO GALVEZ UNIVERSITY OF GUATEMALA

ABSTRACT

Introduction: From 2017 to 2020, strategic actions for obesity prevention have been developed at community level such as assessment of nutritional status and level of food and nutritional insecurity. These strategies have been modified based on the new challenges that have emerged mainly derived from emergencies that have occurred in the last two years, such as the eruption of Volcan de Fuego and the current COVID 19 pandemic. The prevention of obesity represents an important challenge for the country, institutions, families and individuals due to the risk of associated comorbidities and treatment costs. Objectives: Describe nutritional status and food insecurity level to guide obesity strategies and programs in rural communities in Guatemala. Methods: The data obtained from the field work carried out by students and professors in communities of the departments of Chimaltenango, Escuintla, Sacatepéquez and Guatemala was analyzed. Anthropometric indicators BMI /age and Height/age for children under 5 and BMI for adults were used to determine nutritional status and ELCSA scale was applied to assess the level of nutritional food insecurity (INSAN). Results: In 2017, 360 children under 5 in the community of San José El Yalú were diagnosed with 32% stunting, 16% overweight and 80% of households in food insecurity level. In 2019, the nutritional status of 370 scholars in the same community was evaluated, a 51% stunting, 25% overweight, 5% obesity and 95% of homes in food insecurity level were identified showing that stunting and food insecurity worsen in school children and their families, therefore it is necessary to strengthen early interventions in the course of life in these groups. In 2020, the evaluation was carried out on 470 scholars of Jocotenango, Sacatepequez identifying 40% stunting, 25% overweight and 9% obesity, very similar to the groups evaluated in prior years in other communities. Based on these results, audiovisual educational material and interventions were designed focused on scholars which included school gardens, cookbooks, infographics on processed and ultra-processed foods, a tool to assess emotional hunger, education on breastfeeding and a handbook of nutrition education for teachers. Conclusions: Stunting along with overweight and obesity are increasing in children and require continuous assessment and interventions adapted to the socioeconomic and cultural community context. The undergraduate Nutrition program of Universidad Mariano Galvez of Guatemala contributes with basic data to institutions and decision makers at community level for the design of prevention strategies. The systematization of nutritional interventions at community level makes it possible to influence behavior change, mainly if it includes risk assessment and the education and communication component.