Cardiovascular Surgery Unit of Guatemala

Antigua Guatemala, Guatemala

Cardiovascular Surgery Unit of Guatemala

Antigua Guatemala, Guatemala
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PubMed | Cardiovascular Surgery Unit of Guatemala
Type: | Journal: BMC public health | Year: 2016

Smoke-free environments decrease smoking prevalence and consequently the incidence of heart disease and lung cancer. Due to issues related to poor enforcement, scant data is currently available from low/middle income countries on the long-term compliance to smoke-free laws. In 2006, high levels of secondhand smoke (SHS) were found in bars and restaurants in Guatemala City. Six months after a smoking ban was implemented in 2009, levels significantly decreased. However, in 2010, poor law compliance was observed. Therefore, we sought to assess long-term compliance to the ban using SHS measurements.In 2014 we assessed SHS exposure using airborne nicotine monitors in bars (n=9) and restaurants (n=12) for 7days using the same protocol as in 2006 and in 2009. Nicotine was measured using gas-chromatography (g/m(3)) and compared to levels pre- (2006) and post-ban (2009). Employees responded to a survey about SHS exposure, perceived economic impact of the ban and customers electronic cigarette use. In addition, we estimated the fines that could have been collected for each law infringement.Most (71%) venues still have a smoking section, violating the law. The percentage of samples with detectable nicotine concentrations was 100, 85 and 43% in 2006, 2009 and 2014, respectively. In bars, median (25(th) and 75(th) percentiles) nicotine concentrations were 4.58g/m(3) (1.71, 6.45) in 2006, 0.28 (0.17, 0.66) in 2009, and 0.59 (0.01, 1.45) in 2014. In restaurants, the corresponding medians were 0.58g/m(3) (0.44, 0.71), 0.04 (0.01, 0.11), and 0.01 (0.01, 0.09). Support for the law continues to be high (88%) among bar and restaurant employees. Most employees report no economic impact of the law and that a high proportion of customers (78%) use e-cigarettes. A total of US$50,012 could have been collected in fines.Long-term compliance to the smoking ban in Guatemala is decreasing. Additional research that evaluates the determinants of non-compliance is needed and could also contribute to improve enforcement and implementation of the smoke-free law in Guatemala.


Mazariegos M.,Cardiovascular Surgery Unit of Guatemala | Barnoya J.,Cardiovascular Surgery Unit of Guatemala | Barnoya J.,Washington University in St. Louis
Food and Nutrition Bulletin | Year: 2017

Background: Obesity has become a major public health issue in Latin America. Nutrition labels have been proposed as 1 strategy to address the obesity epidemic as they may encourage consumers to reassess their choices at point-of-purchase. Objective: We sought to determine the knowledge and stated use of the nutrition label in Guatemala. Methods: Caregivers were randomly selected from public and private schools in Guatemala City. Caregivers were interviewed to assess knowledge and behaviors related to nutrition label use. Anthropometric measurements were measured using standardized procedures. Descriptive statistics and ‡2 test were used to determine the differences between school types. Results: Higher-income caregivers (88%) were more likely to be aware of nutrition labels, compared to those from low-income families (51%; P <.05). Furthermore, they were more likely to use it more frequently (42.2%) than their counterparts (18.3%; P =.03). Less than 50% of caregivers used nutrition labels for determining the amount of calories or nutritional content in a food portion, to compare nutrient content for different brands of the same food or to select products low in sugar, fat, and/or sodium. Conclusions: Our results provide evidence of the need to further explore nutritional label use and design that can better inform caregivers in Guatemala and other middle-income countries. Furthermore, given that the nutrition labels were for the most part rarely used by the participants in our study and that there are low literacy rates, other straightforward, easy-to-use strategies to communicate nutrition information at the point-of-sale could be useful to explore. © The Author(s) 2016.


Chacon V.,Cardiovascular Surgery Unit of Guatemala | Letona P.,Cardiovascular Surgery Unit of Guatemala | Villamor E.,University of Michigan | Barnoya J.,Cardiovascular Surgery Unit of Guatemala | Barnoya J.,Washington University in St. Louis
Critical Public Health | Year: 2015

Obesity in school-age children is emerging as a public health concern. Food marketing influences preferences and increases children’s requests for food. This study sought to describe the type of snack foods advertised to children in stores in and around public schools and assess if there is an association between child-oriented snack food advertising and proximity to schools. All food stores located inside and within a 200 square meter radius from two preschools and two primary schools were surveyed. We assessed store type, number, and type of snack food advertisements including those child-oriented inside and outside stores. We surveyed 55 stores and found 321 snack food advertisements. Most were on sweetened beverages (37%) and soft drinks (30%). Ninety-two (29%) were child-oriented. Atoles (100.0%), cereals (94.1%), and ice cream and frozen desserts (71.4%) had the greatest proportion of child-oriented advertising. We found more child-oriented advertisements in stores that were closer (<170 m) to schools compared with those farther away. In conclusion, the food industry is flooding the market, taking advantage of the lack of strict regulation in Guatemala. Child-oriented advertisements are available in almost all stores within a short walking distance from schools, exposing children to an obesogenic environment. © 2014 Taylor & Francis.


PubMed | Washington University in St. Louis, University of Michigan and Cardiovascular Surgery Unit of Guatemala
Type: Journal Article | Journal: Critical public health | Year: 2015

Obesity in school-age children is emerging as a public heath concern. Food marketing influences preferences and increases childrens requests for food. This study sought to describe the type of snack foods advertised to children in stores in and around public schools and assess if there is an association between child-oriented snack food advertising and proximity to schools. All food stores located inside and within a 200 square meter radius from two preschools and two primary schools were surveyed. We assessed store type, number and type of snack food advertisements including those child-oriented inside and outside stores. We surveyed 55 stores and found 321 snack food advertisements. Most were on sweetened beverages (37%) and soft drinks (30%). Ninety-two (29%) were child-oriented. Atoles (100.0%), cereals (94.1%), and ice cream and frozen desserts (71.4%) had the greatest proportion of child-oriented advertising. We found more child-oriented advertisements in stores that were closer (<170 m) to schools compared to those farther away. In conclusion, the food industry is flooding the market, taking advantage of the lack of strict regulation in Guatemala. Child-oriented advertisements are available in almost all stores within a short walking distance from schools, exposing children to an obesogenic environment.


Chacon V.,Cardiovascular Surgery Unit of Guatemala | Letona P.,Cardiovascular Surgery Unit of Guatemala | Barnoya J.,Cardiovascular Surgery Unit of Guatemala | Barnoya J.,Washington University in St. Louis
BMC Public Health | Year: 2013

Background: Childhood overweight in Guatemala is now becoming a public health concern. Child-oriented marketing contributes to increase children's food preference, purchase and consumption. This study sought to assess the availability of child-oriented snack foods sold in school kiosks and convenience stores near public schools in Guatemala, to identify the marketing techniques used in child-oriented snack food packages and to classify the snacks as "healthy" or "less-healthy". Methods. We purchased all child-oriented snacks found in stores inside and within 200 square meters from four schools in an urban community. Snacks were classified as child-oriented if the package had any promotional characters, premium offers, children′s television/movie tie-ins, sports references, or the word "child". We used a checklist to assess child-oriented references and price. Snacks were classified as "healthy" or "less-healthy" according to the UK standards for the Nutritional Profiling Model. Results: We analyzed 106 packages found in 55 stores. The most commonly used technique was promotional characters (92.5%) of which 32.7% were brand-specific characters. Premium offers were found in 34% of packages and were mostly collectibles (50%). Most marketing techniques were located on the front and covered nearly 25% of the package surface. Median (interquartile range) price was US$ 0.19 (0.25). Nutrition labels were found in 91 (86%) packages and 41% had a nutrition related health claim. Most snacks (97.1%) were classified as "less-healthy". Conclusion: In Guatemala, the food industry targets children through several marketing techniques promoting inexpensive and unhealthy snacks in the school environment. Evidence-based policies restricting the use of promotional characters in unhealthy snack food packages need to be explored as a contributing strategy to control the obesity epidemic. © 2013 Chacon et al.; licensee BioMed Central Ltd.


PubMed | Washington University in St. Louis and Cardiovascular Surgery Unit of Guatemala
Type: Journal Article | Journal: Globalization and health | Year: 2016

Guatemala, as a party to the Framework Convention on Tobacco Control (FCTC), is required to regulate cigarette packaging and labeling and eliminate illicit tobacco trade. Current packaging and labeling characteristics (of legal and illegal cigarettes) and their compliance with the FCTC is unknown.We sought to analyze package and label characteristics of illegal and legal cigarettes sold in Guatemala. We visited the 22 largest traditional markets in the country to purchase illegal cigarettes. All brands registered on tobacco industry websites were purchased as legal cigarettes. Analysis compared labeling characteristics of illegal and legal packs.Most (95%) markets and street vendors sold illegal cigarettes; 104 packs were purchased (79 illegal and 25 legal). Ten percent of illegal and none of the legal packs had misleading terms. Half of the illegal packs had a warning label covering 26 to 50% of the pack surface. All legal packs had a label covering 25% of the surface. Illegal packs were more likely to have information on constituents and emissions (85% vs. 45%, p<0.001) and were less expensive than legal ones (USD 0.700.7 and 1.91.8, p<0.001).In Guatemala, neither illegal nor legal cigarette packs comply with FCTC labeling mandates. Urgent implementation and enforcement of the FCTC is necessary to halt the tobacco epidemic.

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