Introduction: The prevalence of overweight and obesity in children has increased in recent years, associated with substituting plain water intake with sugar-sweetened beverages. The aim of the study was to evaluate the impact of a school-based intervention that aimed to replace sugar-sweetened beverages with water on Mexican scholars. Methods: We included 314 children aged 9–11 from three public schools of the State of Hidalgo, Mexico, randomized to intervention (two schools from the municipality of Apan; six classes with 146 participants) or control group (one school from the municipality of Emiliano Zapata; six classes with 168 participants) and followed for 6 months. The intervention consisted of placing drinking fountains at schools and classrooms with nutritional education lessons to increase water consumption and decrease sugar-sweetened beverages. Mixed models for repeated measures were used to assess the impact of the intervention. Results: At the end of the study, water consumption was higher (200 mL/day, p = 0.005), and flavored milk consumption was lower (94 mL/day, p = 0.044) in the intervention group compared with the control group. There was also a statistically significant reduction in energy (p = 0.016) and sugar intake (p = 0.007). Conclusions: The school-based intervention favorably modified the consumption pattern of sugar-sweetened beverages and water in Mexican students.

1.
Barquera
S
.
The Mexican experience: from public health concern toward national beverage guidelines
.
Nutr Today
.
2010
;
45
(
6
):
S18
21
.
2.
Barquera
S
,
Rivera
JA
,
Campos
I
,
Hernández-Barrera
L
,
Santos-Burgoa
C
,
Durán
E
, et al
.
Bases técnicas del Acuerdo Nacional para la Salud Alimentaria. Estrategia contra el sobrepeso y la obesidad
.
México
:
Secretaría de salud
.
2010
. Available from: http://www.femecog.org.mx/docs/sobrepeso.pdf.
3.
Gutiérrez
JP
,
Rivera-Dommarco
J
,
Shamah-Levy
T
,
Villalpando-Hernández
S
,
Franco
A
,
Cuevas-Nasu
L
.
Encuesta Nacional de Salud y Nutrición 2012. Resultados nacionales
.
Cuernavaca, México
:
INSP
.
2012
. Available from: https://ensanut.insp.mx/encuestas/ensanut2012/doctos/informes/ENSANUT2012ResultadosNacionales.pdf.
4.
Instituto Nacional de Salud Publica
.
Encuesta Nacional de Salud y Nutricion 2018
.
Presentacion de resultados
.
2018
. Available from: https://ensanut.insp.mx/encuestas/ensanut2018/doctos/informes/ensanut_2018_presentacion_resultados.pdf.
5.
Rivera
,
de Cossío
TG
,
Pedraza
LS
,
Aburto
TC
,
Sánchez
TG
,
Martorell
R
.
Childhood and adolescent overweight and obesity in Latin America: a systematic review
.
Lancet Diabetes Endocrinol
.
2014
;
2
(
4
):
321
32
.
6.
Barquera
S
,
Hernández-Barrera
L
,
Tolentino
ML
,
Espinosa
J
,
Ng
SW
,
Rivera
JA
, et al
.
Energy intake from beverages is increasing among Mexican adolescents and adults
.
J Nutr
.
2008
;
138
(
12
):
2454
61
.
7.
Stern
D
,
Piernas
C
,
Barquera
S
,
Rivera
JA
,
Popkin
BM
.
Caloric beverages were major sources of energy among children and adults in Mexico, 1999-2012
.
J Nutr
.
2014
;
144
(
6
):
949
56
.
8.
Malik
VS1
,
Schulze
MB
,
Hu
FB
.
Intake of sugar-sweetened beverages and weight gain: a systematic review
.
Am J Clin Nutr
.
2006
;
84
(
2
):
274
88
.
9.
Kit
BK
,
Fakhouri
TH
,
Park
S
,
Nielsen
SJ
,
Ogden
CL
.
Trends in sugar-sweetened beverage consumption among youth and adults in the United States: 1999-2010
.
Am J Clin Nutr
.
2013
;
98
(
1
):
180
8
.
10.
Ogden
CL
,
Kit
BK
,
Carroll
MD
,
Park
S
.
Consumption of sugar drinks in the United States, 2005-2008
.
NCHS Data Brief
.
2011
:(
71
):
1
8
.
11.
Rivera
JA
,
Muñoz-Hernández
O
,
Rosas-Peralta
M
,
Aguilar-Salinas
CA
,
Popkin
BM
,
Willett
WC
.
Consumo de bebidas para una vida saludable: recomendaciones para la población mexicana
.
Salud Publica Mex
.
2008
;
50
(
2
):
173
95
.
12.
Gaona-Pineda
E
,
Rodríguez-Ramírez
S
,
Cuevas-Nasu
L
.
Consumo de alimentos y bebidas en niños y adultos
. In:
Olivia Arvizú Martínez Arvizú-Martínez
O
,
Polo-Oteyza
E
,
Shamah-Levy
T
, editors.
Qué y cómo comemos los mexicanos. Consumo de alimentos en la población urbana
.
Mexico
:
Instituto Nacional de Salud Pública, Fundación Mexicana para la Salud
;
2015
. p.
69
92
.
13.
Gandy
J
,
Martinez
H
,
Carmuega
E
,
Arredondo
JL
,
Pimentel
C
,
Moreno
LA
, et al
.
Fluid intake of Latin American children and adolescents: results of four 2016 LIQ.IN 7 National Cross-Sectional Surveys
.
Eur J Nutr
.
2018
;
57
(
Suppl 3
):
53
63
.
14.
James
J
,
Kerr
D
.
Prevention of childhood obesity by reducing soft drinks
.
Int J Obes
.
2005
;
29
(
Suppl 2
):
S54
7
.
15.
Bray
GA
,
Popkin
BM
.
Epidemics of obesity and metabolic disorders: are dietary fats or sugars involved
.
Curr Nutr F Sc
.
2007
;
3
(
2
):
113
21
.
16.
Vartanian
LR
,
Schwartz
MB
,
Brownell
KD
.
Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis
.
Am J Pub Health
.
2007
;
97
(
4
):
667
75
.
17.
Ludwing
DS
,
Peterson
KE
,
Gortmaker
SL
.
Relation between consumption of sugar-sweetened drinks and childhood obesity: a prospective, observational study
.
Lancet
.
2001
;
357
:
505
8
.
18.
Barquera
S
,
Campirano
F
,
Bonvecchio
A
,
Hernández-Barrera
L
,
Rivera
JA
,
Popkin
BM
.
Caloric beverage consumption patterns in Mexican children
.
Nutr J
.
2010
;
9
:
47
10
.
19.
Cunha
DB
,
de Souza Bda
S
,
Pereira
RA
,
Sichieri
R
.
Effectiveness of a randomized school-based intervention involving families and teachers to prevent excessive weight gain among adolescents in Brazil
.
PLoS One
.
2013
;
8
(
2
):
e57498
.
20.
Muckelbauer
R
,
Libuda
L
,
Clausen
K
,
Toschke
AM
,
Reinehr
T
,
Kersting
M
.
Promotion and provision of drinking water in schools for overweight prevention: randomized, controlled cluster trial
.
Pediatrics
.
2009
;
123
(
4
):
e661
7
.
21.
Elder
JP
,
Holub
CK
,
Arredondo
EM
,
Sánchez-Romero
LM
,
Moreno-Saracho
JE
,
Barquera
S
, et al
.
Promotion of water consumption in elementary school children in San Diego, USA and Tlaltizapan, Mexico
.
Salud Publica Mex
.
2014
;
56
(
Suppl 2
):
S148
56
.
22.
Bonvecchio
A
,
Safdie
M
,
Monterrubio
EA
,
Gust
T
,
Villalpando
S
,
Rivera
JA
.
Tendencias de sobrepeso y obesidad en niños mexicanos de 2 a 18 años de edad: 1988 a 2006
.
Salud Publica Mex
.
2009
;
51
:
S586
94
.
23.
Secretaría de Salud
.
Estrategia Nacional para la Prevención y Control del Sobrepeso, la Obesidad y la Diabetes
.
Distrito Federal
.
2013
.
24.
SEP
.
Lineamientos generales para el expendio y distribución de alimentos y bebidas preparados y procesados en las escuelas del Sistema Educativo Nacional
.
2014
.
25.
Quizán Plata
T
,
Anaya Barragán
C
,
Esparza Romero
J
,
Orozco García
ME
,
Espinoza López
A
,
Bolaños Villar
AV
.
Efectividad del programa Promoción de alimentación saludable en estudiantes de escuelas públicas del estado de Sonora
.
Estud Soc
.
2013
;
21
(
42
):
175
203
.
26.
Campbell
SM
.
Hydration needs throughout the lifespan
.
J Am Coll Nutr
.
2007
;
26
(
5 Suppl l
):
585S
7S
.
27.
Gordon
CC
,
Chumlea
WC
,
Roche
AF
.
Stature, recumbent length, and weight
. In:
Lohman
TG
,
Roche
AF
,
Martorell
R
, editors.
Anthropometric standardization reference manual
.
Champaign, Illinois
:
Human Kinetics Books
;
1988
. p.
3
8
.
28.
WHO
.
AnthroPlus for personal computers
.
Geneva
,
World Health Organization
.
2009
. Available from: https://www.who.int/growthref/tools/en.
29.
Hernández-Cordero
S
,
López-Olmedo
N
,
Rodríguez-Ramírez
S
,
Barquera-Cervera
S
,
Rivera-Dommarco
J
,
Popkin
B
.
Comparing a 7-day diary vs. 24 h-recall for estimating fluid consumption in overweight and obese Mexican women
.
BMC Public Health
.
2015
;
15
:
1031
.
30.
Thompson
SG
,
Pyke
SDM
,
Hardy
RJ
.
The design and analysis of paired cluster randomized trials: an application of meta-analysis techniques
.
Stat Med
.
1997
;
16
(
18
):
2063
79
.
31.
Singer
JD
,
Willett
JB
.
Applied longitudinal data analysis – modeling change and event occurrence
.
New York
:
Oxford University Press
;
2003
.
32.
Carriedo
A
,
Bonvecchio
A
,
López
N
,
Morales
M
,
Mena
C
,
Théodore
FL
, et al
.
Use of social marketing to increase water consumption among school-age children in Mexico City
.
Salud Publica Mex
.
2013
;
55
(
Suppl 3
):
S388
96
.
33.
Patel
AI
,
Bogart
LM
,
Elliott
MN
,
Lamb
S
,
Uyeda
KE
,
Hawes-Dawson
J
, et al
.
Increasing the availability and consumption of drinking water in middle schools: a pilot study
.
Prev Chronic Dis
.
2011
;
8
(
3
):
A60
.
34.
von Philipsborn
P
,
Stratil
JM
,
Burns
J
,
Busert
LK
,
Pfadenhauer
LM
,
Polus
S
, et al
.
Environmental interventions to reduce the consumption of sugar-sweetened beverages and their effects on health
.
Cochrane Database Syst Rev
.
2019
;
2019
(
6
).
You do not currently have access to this content.