title: Distribution of macro- and micronutrient intakes in relation to the meal pattern of third- and fourth-grade schoolchildren in the city of Quetzaltenango, Guatemala.
abstract: OBJECTIVE
  Our objective was to assess the distribution of energy, macro- and micronutrient intakes by meal (breakfast, lunch, dinner and combined snacks) in a cross-sectional sample of schoolchildren.
  
  
  METHODS
  Cross-sectional dietary survey in schoolchildren.
  
  
  METHODS
  Twelve private and public schools in the urban setting of Quetzaltenango, Guatemala.
  
  
  METHODS
  A total of 449 schoolchildren (from higher and lower socio-economic strata) were enrolled in the study.
  
  
  METHODS
  Each child completed a single, pictorial 24 h prospective diary and a face-to-face interview to check completeness and estimate portion sizes. Estimated daily intakes were examined by mealtime as: (i) absolute intakes; (ii) relative nutrient distribution; and (iii) critical micronutrient density (i.e. nutrient density in relation to the WHO Recommended Nutrient Intakes/median age-specific Guatemalan energy requirements).
  
  
  RESULTS
  The daily distribution of energy intake was 24% at breakfast, 30% at lunch, 23% at dinner and 23% among snacks. Lunch was also the leading meal for macronutrients, providing 35% of proteins, 27% of fat and 30% of carbohydrate. The distribution of selected micronutrients did not follow the pattern of energy, insofar as lunch provided relatively more vitamin C and Zn, whereas breakfast led in terms of vitamins A and D, thiamin, riboflavin, folate, Ca and Fe.
  
  
  CONCLUSIONS
  Meal-specific distribution of energy, macro- and micronutrients provides a unique and little used perspective for evaluation of children's habitual intake, and may provide guidance to strategies to improve dietary balance in an era of coexisting energy overnutrition and micronutrient inadequacy.
authors.affiliation: Center for Studies of Sensory Impairment, Aging and Metabolism, Guatemala City, Guatemala. mvossenaar@hotmail.com
authors.forename: Marieke
authors.initials: M
authors.lastname: Vossenaar
authors.forename: Gabriela
authors.initials: G
authors.lastname: Montenegro-Bethancourt
authors.forename: Lothar D J
authors.initials: LD
authors.lastname: Kuijper
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Doak
authors.forename: Noel W
authors.initials: NW
authors.lastname: Solomons
mesh_terms: D002648:Child; D002664:Child Nutritional Physiological Phenomena; D003430:Cross-Sectional Studies; D004032:Diet; D004034:Diet Surveys; D004040:Dietary Carbohydrates / Q000008:administration & dosage; D004041:Dietary Fats / Q000008:administration & dosage; D004043:Dietary Fiber / Q000008:administration & dosage; D004044:Dietary Proteins / Q000008:administration & dosage; D004435:Eating / Q000502:physiology*; D002149:Energy Intake / Q000502:physiology*; D005260:Female; D006166:Guatemala; D006801:Humans; D008297:Male; D018977:Micronutrients / Q000008:administration & dosage*; D009751:Nutritional Requirements; D012574:Schools; D012959:Socioeconomic Factors
chemical_list: D004040:Dietary Carbohydrates; D004041:Dietary Fats; D004043:Dietary Fiber; D004044:Dietary Proteins; D018977:Micronutrients