ArticlePloS one2021
Poor compliance with school food environment guidelines in elementary schools in Northwest Mexico: A cross-sectional study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it, 13 citations in OpenAlex.
- Towards a comprehensive school food environment audit tool in Canada: a systematic review of school food environment measurements and nutrition determinants.BMC public health · 2025Pooled it
- Cross-Sector Policies for Achieving Equitable Obesity Prevention and Food Security: A Review of Real-World Actions.Current obesity reports · 2026Review
- Supply and advertising of food and beverages with front-of-package warning labeling in schools of Metropolitan Lima 2023.Revista peruana de medicina experimental y salud publica · 2026Article
- Food Environment Assessment in Primary Schools Before the Implementation of Mexico's 2025 School Food Guidelines: A Mixed Method Analysis.Children (Basel, Switzerland) · 2026Article
- The School Food Environment in Ghana is Associated With Dietary Diversity and Anemia: Findings From the 2022 National Nutrition and Health Survey of In-School Adolescents.Food and nutrition bulletin · 2025Article
- Assessment of School Food Policy Influencing Nutritional Behaviour of Adolescents from the Perspective of School Stakeholders in Ibadan, Oyo State.International journal of environmental research and public health · 2025Article
- A Scoping Review of School-Based Nutrition and Physical Activity Interventions Conducted in Mexico.American journal of lifestyle medicine · 2025Review
- Predicted impact of banning nonessential, energy-dense food and beverages in schools in Mexico: A microsimulation study.PLoS medicine · 2024Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn Mexico, 35.5% of school-age children were overweight or obese in 2018. The school food environment is important because children spend a significant part of their time at school and consume one-third to one-half of their daily meals there. In 2014, a Federal Government guideline for the sale and distribution of food and beverages in Mexican schools was published (the AGREEMENT) but the extent of its implementation is not known.
methodsDescriptive cross-sectional study in a representative, random sample of elementary schools, using the tools of the INFORMAS network. Data collection included: a) an interview with a school authority; b) a checklist of items available in the school canteen; c) a checklist of the school breakfast menu; and d) an evaluation of the physical environment. The main indicators were: percentage of implementation (self-report) of the AGREEMENT and percentage of compliance (researcher verified) with the AGREEMENT (based on tools b and c).
results119 schools participated (response rate 87.5%), with 15.1% (95%CI 9.2-22.8) of the schools reporting having fully implemented the AGREEMENT. However, only 1% (95%CI 0-5.3) of the school canteens and 71.4% (95%CI 57.8-82.7) of the school breakfast menus fully complied with the AGREEMENT. A variety of sugar-sweetened beverages and energy-dense, nutrient poor products were found in the school canteens. Further, only 43.7% of the water fountains in schools were functional and 23.4% were clean. In only 24.4% of schools had the school authorities received formal training related to the AGREEMENT and in 28.6% of schools had the parents received information about the AGREEMENT.
conclusionThe AGREEMENT has been poorly implemented in elementary schools in Mexico. Actions are needed to encourage and support its full implementation to improve the food environment in Mexican schools.
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