Unhealthy and healthy food consumption inside and outside of the school by pre-school and elementary school Mexican children in Tijuana, Mexico.

Food from lunch packs (LP) or food available inside and outside of school can play an important role in the development of obesity. The purpose of this study was to evaluate the LP of elementary school (ES) and preschool children (PS) in Tijuana, and the foods available to them inside and outside of school. Eight public schools participated in the study. A random sample of all the groups from a school district was conducted. A questionnaire was administered to children in first through sixth grade (ES) and to the parents of PS. LP and food available inside and outside of the school were classified as healthy, unhealthy, and adequate according to the guidelines set forth by the Secretariat of Health. A total of 2,716 questionnaires were administered and the content of 648 LP was assessed. It was observed that 99% of PS had LP prepared at home, a higher percentage than ES. None of the LP of the ES was classified as healthy, and 1% was classified as adequate. Among PS, 21% of the LP were classified as healthy and 6% as adequate. More than half of the children recognized the brand name of foods high in fat, salt, and added sugar available inside and outside of school grounds. Most of the LP of ES and PS and the foods available inside and outside of school were unhealthy and inadequate. A strategy to prevent the availability of unhealthy and inadequate food in LP and foods available inside and outside schools is recommended.