Brief Communication

Characteristics of the lunch box of pre-school children and nutritional knowledge of the carer: A pilot study in Lima, Peru, 2016

Características de la lonchera del preescolar y conocimiento nutricional del cuidador: un estudio piloto en Lima, Perú, 2016

Lupe Arévalo-Rivasplata^a, Susan Castro-Reto^a, Geraldine García-Alva^a, Eddy R. Segura^a,b

^aEscuela de Nutrición y Dietética, Universidad Peruana de Ciencias Aplicadas, Lima, Perú
^bDepartment of Medicine/Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Ángeles, California, Estados Unidos

Mr. Editor:

Overweight and obesity in preschool children are a growing Public Health problem. In Peru, in the year 2015, 6.5% of children under 5 years old who went to health facilities at the national level were overweight, and 1.5% were obese¹. The possible causes are food modernization with higher production and consumption of processed foods, which are rich in simple sugars and saturated fats², and also inadequate knowledge of the person in charge of preparing the preschool lunchbox³. Here we report the findings of a pilot study of the characteristics of a common lunchbox from a sample of preschoolers in Lima, Peru, and the level of nutritional knowledge of their caregivers.

During May 2016, we interviewed 30 caregivers (parents, mothers or others) of 30 preschool children (under 6 years old) selected by convenience from a private school in Lima. We evaluated the caloric composition of macronutrients and food groups in the lunch boxes using the direct weight method and tables (Peruvian food composition table, composition table of industrialized foods and Food Composition Table of Central America). We measured the knowledge of caregivers about preschool nutrition by adapting a questionnaire from a previous study⁴. Then, we compared the characteristics between the high and low knowledge groups (divided by the median score) using Wilcoxon and Fisher’s exact tests. Results are shown in table 1.

Table 1. Characteristics of lunchboxes and caregivers according to their level of nutritional knowledge (n = 30)

The Low Level Knowledge group included industrialized foods in greater proportion, and had higher carbohydrate content. A longitudinal study in Mexico in 2010 found that 53.6% of the products contained in preschool’s lunchboxes were industrialized products, although this study did not evaluate the level of knowledge⁵. Although the indicators that we compared are not the same, both scenarios demonstrate the poor nutritional quality of the lunchboxes in different realities. In addition, the lunchboxes of the Low Level of Knowledge group did not include any vegetables, and had fewer fruits compared to the High Level of Knowledge group, although the difference was not statistically significant. This finding may be due to a shift or substitution of products by the caregiver, probably explained by the levels of nutritional knowledge and/or the ease of disposition and non-preparation inherent in industrialized products.

In conclusion, our pilot study showed that the nutritional quality of preschool’s lunchboxes is different according to the caregiver’s knowledge. Greater presence of industrialized foods, higher carbohydrate content, and less presence of fruits and vegetables are more frequent when their knowledge is low. We can not conclude that knowledge is the main determinant of this difference, and it is possible that other factors (economy, time, ease, etc.) also influence this difference. Future studies on lunchboxes in preschoolers should include anthropometric measurements, more comprehensive assessments of the caregiver and also they be executed longitudinally in an epidemiological surveillance way. Such results would better target messages to target populations in campaigns that promote healthy lunchboxes.

References

1. Ministerio de Salud Estado nutricional en niños y gestantes de los establecimientos de salud del Ministerio de Salud - Informe gerencial nacional. Lima: MINSA; 2015.

2. Miranda-Cipriano O, Gómez-Guizado G, Munares-García O, Aquino-Vivanco O. Valores percentilares del contenido de azúcar, grasas, y sodio en alimentos industrializados según etiquetado expendidos en Lima. Bol Inst Nac Salud. 2014;20:104-10.

3. Bonilla S. Efecto de intervención educativa sobre el conocimiento de las madres y mejora de preparación de lonchera del pre escolar. Tesis. Lima: Escuela de Enfermería de Padre Luis Tezza; 2015.

4. Vereecken C, Maes L. Young children’s dietary habits and associations with the mother’s nutritional knowledge and attitudes. Appetite. 2010;54:44-51.

5. Reyes D, Reyes U, Sánchez N, et al. Alimentos contenidos en la lonchera de los ni˜nos que acuden a un preescolar. Bol Clin Hosp Infant Edo Son. 2010;27:35-40.

Correspondencia a:

Geraldine García-Alva

gerig1296@gmail.com