The industry uses nutrition and health claims, premium offers, and promotional characters as marketing strategies (MS). The inclusion of these MS on ultra-processed products may influence child and adolescent purchase behavior. This study determined the proportion of foods carrying claims and marketing strategies, also the proportion of products with critical nutrients declaration, and nutritional profile differences between products that carry or not claims and MS on the front-of-package (FoP) of ultra-processed food products sold in Costa Rica. Data were obtained from 2423 photographs of seven food groups consumed as snacks that were sold in one of the most widespread and popular hypermarket chains in Costa Rica in 2015. Ten percent of products lacked a nutrition facts panel. Sodium was the least reported critical nutrient. Energy and critical nutrients were significantly highest in products that did not include any nutrition or health claim and in products that included at least one MS. Forty-four percent and 10% of all products displayed at least one nutrition or at least one health claim, respectively, and 23% displayed at least one MS. In conclusion, regulations are needed to restrict claims and marketing on ultra-processed food packages to generate healthier food environments and contribute to the prevention of childhood and adolescent obesity in Costa Rica.

Objective: This article analyses the relationship between socio-economic status and the prevalence of overweight and obesity in the primary school population in Costa Rica.Design: A National School Weight/Height Census was disseminated across Costa Rica in 2016. The percentage of children who were overweight or obese was calculated by sex, age and socio-economic indicators (type of institution: private, public, mix; type of geographic location: rural, urban and the level of development of the district of residence: quartiles). A mixed-effects multinomial logistic regression model and mixed-effects logistic regression model were used to analyse the association between the prevalence of being overweight or obese and district socio-economic status.Setting: The survey was carried out in public and private primary schools across Costa Rica in 2016.Participants: In total, 347 366 students from 6 to 12 years were enrolled in public and private primary schools.Results: The prevalence of overweight and obesity among children was 34·0 %. Children in private schools were more likely to be overweight or obese than students in public schools (OR = 1·10 [1·07, 1·13]). Additionally, children were less likely to be overweight or obese if attending a school in a district of the lowest socio-economic quartile compared with the highest socio-economic quartile (OR = 0·79 [0·75, 0·83]) and in a rural area compared with the urban area (OR = 0·92 [0·87, 0·97]).Conclusions: Childhood obesity in Costa Rica continues to be a public health problem. Prevalence of overweight and obesity in children was associated with indicators of higher socio-economic status.

This article analyses the association between consumption of tobacco and alcohol among Costa Rican women ages 15 to 49. A National Women, Children, and Adolescents Survey was disseminated across Costa Rica in 2018 (n = 7,487). The percentages of women who consumed tobacco and alcoholic beverages were calculated by age, socio-economic indicators, and civil status. A logistic regression design was used to analyze the relationship between tobacco and alcoholic beverages consumption. The relationship between tobacco and alcohol consumption was confirmed. Women who consumed alcohol four times or more in the past month had a higher prevalence of tobacco use (OR = 18.80 [11.25-31.41]). On the other hand, women who smoke had a lower prevalence of alcohol consumption (OR = 4.09 [2.67-6.26]) than women who smoke occasionally (OR = 8.86 [4.83-16.24]). There is an association between tobacco consumption and alcohol consumption in women between 15 and 49 years old. This relationship is present with greater force in young, single women and residents of urban areas.

La región latinoamericana ha sido pionera en la implementación del etiquetado frontal de advertencia nutricional (EFAN), mismo que ha demostrado su eficacia y efectividad para identificar correctamente cuando un producto contiene cantidades excesivas de nutrientes asociados a Enfermedades no transmisibles (ENT). Sin embargo, ningún país del Sistema de la Integración Centroamericana (SICA); que incluye a Belice, Costa Rica, El Salvador, Guatemala, Honduras, Nicaragua, Panamá y República Dominicana, lo ha adoptado. Por esta razón, el Instituto de Nutrición de Centro América y Panamá, convocó a un grupo de expertos de la academia y la sociedad civil con el objetivo de establecer una postura técnica, basada en la mejor evidencia científica, en relación al etiquetado frontal para los nutrientes críticos de alimentos y bebidas pre- envasados en la región centroamericana. Se presenta evidencia específica de la región del SICA que demuestran la superioridad del EFAN frente a otros etiquetados como las Guías Diarias de Alimentación (GDA), el semáforo y el Nutriscore para seleccionar opciones más saludables. Dentro del marco de los derechos de la niñez y de los consumidores, se brindan argumentos y se hace un llamado a los gobiernos para la pronta adopción del EFAN como una política costo-efectiva para la prevención de ENT. Además, se proveen recomendaciones para su monitoreo y evaluación, así como recomendaciones de otras políticas costo-efectivas como la regulación de la publicidad de alimentos no saludables dirigido a la niñez y adolescencia, entre otros, para la prevención de las ENT y la creación de ambientes y sistemas alimentarios más saludables y sostenibles.

El objetivo de esta investigación fue comparar las principales características que influyen en el funcionamiento de los Programas de Alimentación Escolar (PAE) en escuelas urbanas y públicas de Costa Rica y Guatemala y la percepción de la comunidad escolar sobre dicho funcionamiento. Se realizó una revisión documental de informes y normativas vigentes relacionadas con los PAE de cada país para comparar características principales. Se realizaron 32 entrevistas y 43 grupos focales con la comunidad escolar para captar sus percepciones sobre el funcionamiento. Se realizó un análisis temático de transcripciones aplicando teoría fundamentada. Como principales hallazgos, se destaca que los PAE en Costa Rica y Guatemala han sido una estrategia para luchar contra el hambre y malnutrición infantil, contando ambos países con un gran respaldo normativo y político que le da sostenibilidad. Sin embargo, existen barreras como recursos limitados, problemas administrativos y falta de fiscalización de las normas. En conclusión, apesar de que en ambos países existe una normativa robusta para hacer cumplir el derecho a una alimentación saludable, se encontraron algunas barreras que dificultan una correcta implementación del PAE.