A brief summary of: Nutritional status and risk factors related to the health of

primary school students attending the “José Ernesto Monzón Reyna” Mixed Rural
Official School of “Sajquíyes Montúfar” Village, San Juan Sacatepéquez, in 2020.

Henry Lewis

Introduction

The World Health Organization (WHO) defines health as a state of complete physical,
mental and social well-being, and not only the absence of conditions or diseases (WHO,
2018a). Indeed, health is a state that can always be improved and that is intimately related
to the environment in which people live into and develop. One of the main factors influencing
health is food; adequate nutrition is achieved by consuming a variety of foods in adequate
portions to meet recommended energy and protein requirements (The World Health
Organization, 2016). Unhealthy diets lead to the development of chronic non-communicable
diseases and diseases by deficiencies. It is recognized that a large percentage of the
population in Guatemala lacks or has limited access to nutritious food and/or has eating habits
that do not favor adequate nutrition, such as not having breakfast or meeting eating hours,
drinking little water, eating junk/fast food and light drinks, etc. (Food and Agriculture
Organization of the United Nations, 2010). The scope of the present summary is to briefly
describe the background and findings regarding the undergraduate medical school Thesis that
took place in 2020 that examined the nutritional status and risk factors related to the health
of primary school students of a Guatemalan village.

Motivation

Since chronic malnutrition rates in school-age children and young people have now
reached alarming levels throughout the country, (FAO, PAHO, WFP and UNICEF, 2018)
the purpose of this research is to: in addition to assessing nutritional status and identifying
risk factors that threaten and may adversely affect the health and critical development of the
school population under study, serve as a theoretical basis for future studies that aim to
address the prevention of nutritional disorders and the increase in morbidity and mortality
associated with malnutrition in infants, children and adolescents. Such objectives were driven
towards the school population at the primary level of the José Ernesto Monzón Reyna Rural
School, San Juan Sacatepéquez, Guatemala.

Background

It is of great importance to be aware of health indicators, which consists of measures

that monitor health status and trends or health-related factors; something that reflect the
health status of a population. They identify critical areas for the establishment of health
policies and priorities, based on the stratification of epidemiological risk and those human
groups with greater health needs. These indicators contain socio-demographic, morbidity,
epidemiological surveillance, and mortality aspects, as well as definitions and comments for
the management of these. Such health-related indicators are often used in various
combinations to evaluate the achievement of health goals, which is why WHO has defined
them as variables that serve to measure changes. (Pan American Health Organization, 2018).
According to WHO, malnutrition includes overweight, obesity, non-communicable food-
related diseases, lack or excess of vitamins or minerals, and malnutrition, the latter related to
stunting (insufficient height for age), wasting (insufficient weight for height) and
underweight (insufficient weight for age) (Food and Agriculture Organization of the United
Nations, 2010; WHO, 2009).

It is worth mentioning that in Guatemala, there is a strategy called 1000-day window,

which seeks to reduce maternal and infant mortality and prevent chronic malnutrition in a
comprehensive way in health and nutrition. This stage is defined as the period from
pregnancy to two years of the child’s life; in which mother and child are guaranteed prenatal
care, skilled childbirth care, adequate feeding practices including breastfeeding, vitamin, and
mineral supplementation (if necessary) and treatment of malnutrition, among other ailments.
Adequate nutrition is important in this period of life because it is where individuals manage
to develop to the maximum their physical and intellectual potential (Pan American Health
Organization, 2013).

Methodology

A cross-sectional, descriptive study was conducted, where the sample size was
selected based on the entire population of children enrolled in the "José Ernesto Monzón
Reyna Mixed Rural Official School", between the ages of 10 and 16 years and who knew
how to read and write. Only those who did not want to participate in the study were excluded.
Each participant completed the "Global School Health Survey " (WHO, 2018) anonymously
and voluntarily under the supervision of researchers. The "National Education Monitoring
Questionnaire in Schools" is applied, with the aim of investigating issues related to access to
drinking water, the existence and state of sanitary facilities and drains, waste disposal and
hygiene issues. Then the answers were immediately entered into the Redcap platform, as well
as taking anthropometric measurements in Excel, for tabulation.

The nutritional status assessment based on anthropometric measurements of weight

and height was carried out in a population of 144 children of both sexes, aged between 10
and 16 years. For the interpretation of the collected data, the growth patterns recommended
by the WHO were used (Growth reference data for 5-19 years ) (Mercedes de Onis, 2007).
The height index for age, an indicator of chronic malnutrition, was classified based on Z
scores as follows: normal height, (Z between -2 and + 2), short stature (Z between <-2 and -
3), severe short stature (Z < -3). The Body Mass Index classification, BMI for age resulting
from the weight-to-square ratio, was classified as: severely emaciated (Z < -3), emaciated
(Z< -2), normal (Z between 0 and <-1) possible risk of overweight (Z > +1), overweight (Z
> +2), obese (Z > +3).
 Conclusion

The results of the study showed that 45.1% of the population had chronic
malnutrition, and the 10-11 age group and women were more affected. The results show that
9.7% of the children surveyed are in a state of wasting, mostly in the group of men, while
8.3% were overweight, conditions that expose the health and integral well-being of children,
as well as their psychomotor and cognitive development. The other part of the study focused
on evaluating all the risk factors external to the individual that can somehow lead to the
development of malnutrition and the risks that come from such disorders. The main topics
addressed in the survey are alcohol consumption, tobacco and/or drugs, eating habits,
physical activity, hygiene, mental health, sexual behavior, violence, and unintentional
injuries.
Within the eating habits it was found that approximately 52.8% of the population do
not have access to breakfast, food time quite important to interrupt the period of fasting the
night before and provide energy to the body and brain. Regarding hygiene and personal care,
65.3% brush their teeth 3 times a day; a habit recommended by dentists to enjoy adequate
oral health. Hand washing allows the prevention and spread of respiratory and diarrheal
diseases from one person to another. For this reason, it was inquired about this issue in which
it was found that 65.3% wash their hands before eating and 59.0% do it after using the
bathroom or latrine, in this group, 77.1% do it with water and soap. It is not known if a proper
hand washing technique is performed according to the WHO.
One of the positive findings that should be noted from the study, was to find that
93.10% of respondents have never consumed alcohol. WHO estimates that alcohol
consumption among young people begins before age 15 in many countries; in our research it
is reported that 7.30% of the surveyed population consumed alcohol before this age. Also,
100% reported not having used tobacco or any type of illicit drug (marijuana, ecstasy,
cocaine, etc.).

References
FAO, PAHO, WFP and UNICEF. Latin America and the Caribbean Regional Overview of
Food Security and Nutrition 2018. Latin America and the Caribbean – Regional
Overview of Food Security and Nutriton.
https://www.fao.org/publications/card/en/c/CA2127EN
Food and Agriculture Organization of the United Nations. (2010). Nutrition-sensitive
family farming is the key to combating malnutrition. FAO.
https://www.fao.org/guatemala/noticias/detail-events/fr/c/1156881/
Mercedes de Onis (2007). Development of a WHO growth reference for school-aged
children and adolescents. Advance online publication.
https://doi.org/10.2471/blt.07.043497
Pan American Health Organization. (2013)). Launch Window of a thousand days.
Pan American Health Organization. (2018). Health Situation in the Americas: Core
Indicators. https://iris.paho.org/handle/10665.2/49511
WHO. (2009). Global health risks: Mortality and burden of disease attributable to selected
major risks. World Health Organization.
WHO (2018a). How does WHO define health?
https://www.who.int/es/about/governance/constitution
WHO. (2018b). World Health Organization. Global School-based Student Health Survey
(GSHS). World Health Organization. Global School-based Student Health Survey
(GSHS). 2018. https://www.who.int/teams/noncommunicable-
diseases/surveillance/systems-tools/global-school-based-student-health-survey/
The World Health Organization. (2016). Pan American Health Organization Nutrient
Profile Model.
https://iris.paho.org/bitstream/handle/10665.2/18622/9789275318737_spa.pdf