Childhood Nutrition in Chile: An Assessment of a National School Food Program Open Access

Altman, Emily Ann (2013)

Permanent URL: https://etd.library.emory.edu/concern/etds/bg257f381?locale=en
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Abstract

The purpose of this thesis is to explore school food and its impact on overall health in Chile. Specifically, the goals of the present research are to identify the policy associated with Chile's national school food program, El Programa de Alimentación Escolar, understand how the program operates on a local level, and explore how government officials, private food providers, and schoolchildren perceive and function within the program. Ultimately, this thesis aims to identify possible enhancements to the program.

This thesis will first present an overview of Chile's historical and economic context, as well as the recent nutrition transition and the country's changing food landscape. Following will be a discussion of the relationship between diet and health and the importance of schools as sites for nutrition interventions. Once this foundation is established, the thesis will discuss Chile's school food program and other successful nutrition interventions in schools around the world.

Using ethnographic observations of school lunches, a survey with a group of schoolchildren, and interviews with a government official, private food vendors, and experts in the field of childhood nutrition and school food, this research illustrates the need for increased attention to school food as a tool to teach and promote healthy lifestyles among children. Although most schoolchildren consumed breakfast and lunch in school everyday, the food that schools served them lacked important food components, namely fruits and vegetables. In addition, kiosks located in schools, which offered mainly processed snacks at low prices, were popular among students. Schoolchildren generally understood what foods to eat in order to remain healthy and also reported a preference for fruit. However, they rarely enacted this knowledge and subsequently consumed many unhealthy foods in the school environment.

Based on the findings of the present research, this thesis presents a series of simple, evidence-based recommendations detailing possible improvements for Chile's school food program. These recommendations target the macro, policy-level, as well as the micro-level of the program and include increasing government involvement and monitoring of the program, serving more fruits and vegetables, decreasing processed foods offered, and incorporating nutrition education into schools.

Table of Contents

INTRODUCTION ....................................................................................................................... 1

BACKGROUND ...........................................................................................................................6

Chile's Historical and Economic Context ...........................................................................................6

The Nutrition Transition ................................................................................................................8

Chile's Changing Food Landscape ...................................................................................................11

Diet and Health ..........................................................................................................................16

Schools as Sites for Nutrition Interventions .....................................................................................17

Case Study: Programa de Alimentación Escolar - Chile's School Food Program ......................................21

School Food Programs Around the World ........................................................................................22

Implications ..............................................................................................................................24

METHODOLOGY ........................................................................................................................26

Research Design .........................................................................................................................26

Data Collection ...........................................................................................................................27

RESEARCH FINDINGS ...............................................................................................................31

Chile's School Food Program ........................................................................................................31

Implementation of PAE in Arica ....................................................................................................33

General Importance ...................................................................................................................39

DISCUSSION AND ANALYSIS ....................................................................................................41

The Program .............................................................................................................................41

The Food ..................................................................................................................................44

The Children .............................................................................................................................48

Limitations of the Research .........................................................................................................59

RECOMMENDATIONS ................................................................................................................61

Recommendation 1 .....................................................................................................................62

Recommendation 2 .....................................................................................................................64

Recommendation 3 .....................................................................................................................67

CONCLUDING REMARKS ............................................................................................................72

REFERENCES ............................................................................................................................75 TABLES:

Table 1: Survey for Chilean Schoolchildren .....................................................................................28

Table 2: Interview Questions for Kiosk Owners ................................................................................29

Table 3: Interview Questions for JUNAEB Official .............................................................................29

Table 4: Interview Questions for Experts in the Field ........................................................................30

Table 5: School Lunch Menu .........................................................................................................34

Table 6: Summary of Children's BMI-for-Age ..................................................................................35

Table 7: Consumption Patterns at School ........................................................................................36

Table 8: Food Preferences ...........................................................................................................37

Table 9: Ranked Food Preferences .................................................................................................38

FIGURES:

Figure 1: Prevalence of Overweight and Obesity, by Gender ..............................................................36

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