Consumption of Sugar-Sweetened Beverages and Low Nutrient Density Foods in Central America

Use these illustrations when helping educate Central American communities. You can download and print full-size versions by clicking on the thumbnail-size versions below.

Overweight Illustration: Illustration: Overweight person Lollipop Illustration: Illustration: lollipop

Illustration of overweight woman with soda and chips

Illustration of child with candy and poor oral health

Over consumption of highly processed foods and sugar-sweetened beverages is a growing health concern in Central America. According to a 2015 Academy of Nutrition and Dietetics survey of health professionals with experience in Central America, many communities in Central America have easy access to low-nutrient density foods with added fats and sugars — foods that supply calories but few micronutrients — and poor access to a variety of nutrient-dense foods. Low-nutrient density foods with added fats and sugars are commonly prominent in stores and are typically less expensive than nutrient-dense foods.

Marketing of sugar-sweetened beverages and westernized foods in Central America is rampant and includes in-store, television and billboard advertisements. Community members often lack awareness of the risk of these foods and the harm they can do to the body when overconsumed. Survey respondents voiced concern that since low-nutrient density foods with added fats and sugars are readily available and nutrient-dense fresh goods are either difficult to find or more costly, Central Americans are consuming more nutrient-poor foods than ever before.

Rising Health Issues and Dietary Concerns

Obesity is an increasing health trend in Latin America, especially in countries with urban areas and those that are emerging from poverty. Rural diets tend to be higher in fruits, vegetables and grains while urbanized diets are associated with higher levels of total fat, refined carbohydrates and added sugars with reduced amounts of dietary fiber. Poor diet along with a sedentary lifestyle increases the risk of chronic diseases such as obesity, diabetes, hypertension and dyslipidemia, all of which are becoming more common in Central America. Research predicts diabetes rates will exponentially increase by 2030 in Central America, with countries like Costa Rica and Panama at an even greater risk of diabetes prevalence to more than 10% in 2025 due to their larger urban population.

In rural areas of Nicaragua, researchers estimate that 42% of 6-month-old children and 32% of 8-month-old children regularly consume highly processed snacks and sugar sweetened beverages. When the consumption of sugar-sweetened beverages and refined foods begins at such an early age, it disrupts exclusive breastfeeding. These high-sugar foods and beverages replace nutrient-dense options and therefore raise concerns for various growth and development issues. Even the smallest villages in rural Central America may have stores that sell both high- and low-quality food items, with the low-quality food items often being more accessible and affordable.

Health concerns regarding consumption of highly processed foods and sugar-sweetened beverages at an early age include increased risk for obesity, hypertension, infections and inadequate intake of key macro- and micronutrients, which may impair growth and promote stunting. Sugar-sweetened coffee, tea, soda and heavily sweetened grain drinks are commonly given in bottles as infant foods in lieu of breast milk. Health educators should communicate to caregivers the importance of exclusive breastfeeding until six months along with proper foods to introduce in the weaning process with adequate macro- and micronutrients that promote successful growth and development.

Poor oral health is another issue resulting from the over consumption of sugary foods in Central America. Communities that have limited or no access to toothbrushes, toothpaste and dental care are especially affected from problems related to tooth decay.

Educating Communities about Nutrient-Rich Foods

In developing countries, where a third-grade education is often the average educational level, the concepts of nutrients such as protein and vitamins are poorly understood. It is not common knowledge that foods with added sugar can be harmful. Health educators should include lessons on nutrient-dense foods to help increase understanding of foods that support healthy lifestyles. Nutrition education should explain what nutrients are, how they benefit the body, and the difference between nutrient-dense and low-nutrient density foods.

Explaining the benefits of nutrient-rich food may also require discussions with families about allocating enough money to purchase those foods. People who live in developing areas of Central America typically have a limited food budget, and since low-nutrient foods are often the most affordable, families may think it's in their best interest, financially, to purchase those types of foods. Finding healthier choices that fit in a family's budget is imperative, as is presenting nourishing foods that are available in the geographical region and commonly eaten by the local population. Gaining this information in advance and properly preparing for the lesson is ideal.

Communicating the Importance of Drinking Water

Community attitudes and norms affect food and beverage consumption. Community members in developing areas of Central America commonly believe sugar-sweetened beverages to be healthier, cheaper or more sanitary than water. There is seldom a culture of drinking plentiful water, perhaps because clean running water is often not available. Education about the benefits of water and how clean water can be made available could help change attitudes about sugar-sweetened beverage consumption. Bringing potable water to rural communities is a key priority for public health efforts that also could help to reduce sugar-sweetened beverage consumption.

Techniques for Teaching about Nutrient Density

An effective format for nutrition education is simple educational tools with colorful, realistic illustrations. Because this population has minimal literacy, it is essential for education materials to have limited text. Educators should show refined foods containing added fats and sugars that supply calories without many nutrients, including sugar-sweetened beverages, along with nutrient-dense foods to replace them with in the diet.

It is encouraged to show actual foods or use food models if available. Nutrient comparison cards for nutrient-dense and nutrient-poor foods are also very helpful visuals for populations that do not know much about nutrients but can understand the contrasting visuals these cards provide. Demonstrations of how the money used for purchasing nutrient-poor foods could be used to purchase various nourishing foods are also powerful.

Additional Resources

  • Contreras M, Zelaya Blandon E, Persson LA, Ekstrom EC. Consumption of highly processed snacks, sugar-sweetened beverages and child feeding practices in a rural area of Nicaragua. Matern Child Nutr. 2014.
  • Hoy-Rosas J, Arrecis E, Avila M. Central American Food Practices. In Goody C, Drago L. Cultural Food Practices. United States of America. American Dietetic Association; 2010: 54-67
  • Pena M, Bacallao J. Obesity and Poverty: A New Public Health Challenge. World Health Organization website. Published 2000. Accessed June 20, 2016.
  • Uauy R, Albala C, Kain J. Obesity trends in Latin America: Transitioning from under- to overweight. J Nutr. 2001;131(3):893S-899S.
  • Uauy R, Monteiro CA. The challenge of improving food and nutrition in Latin America. Food Nutr Bull. 2004;25(2):175-182.
  • Wild S, Roglic G, Green A, Sicree R, et al. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004;27(5):1047-53.