Consumption‐temperatures of local thin gruels ( atoles ) among low‐income women from Quetzaltenango, Guatemala: Implications for mitigation of upper digestive cancer risk

Background Worldwide, traditional foods are mainly starch‐based, derived from cereals such as maize, wheat, oats and rice, often consumed in porridge or thin‐gruels preparations. In Guatemala, thin gruels ( atoles ) are widely consumed across the population, especially by lactating women. By recent consensus, drinking beverages above 65°C is a risk factor for esophageal cancer. Little is known about the temperature of consumption of gruels in the Guatemalan population. A pair of small studies provides initial insights into this health‐relevant behavior. Objective To explore practices surrounding temperature preparation and consumption of thin gruels among low‐income women from rural, semi‐urban and urban areas in the Department of Quetzaltenango, Guatemala. Methods Study 1: 11 low‐income homes in San Mateo (rural), La Esperanza (semi‐urban) and Quetzaltenango City (urban) were visited to enroll women to prepare a gruel of their choice for a visit on the subsequent morning. The temperature of the gruel at the moment it was served from the pot into a cup and at that of the consumption by the host‐preparer was assessed by holding a pocket digital food thermometer (Johnson‐Rose® brand) half way into the cup without stirring the contents. Study 2: 72 low‐income women, 24 each from 3 areas were recruited at health centers and invited to participate. The areas were: San Juan Ostuncalco (rural); La Esperanza (semi‐urban); and Quetzaltenango City (urban). Women were asked to prepare a gruel of election, and bring it to the study site in the vacuum flasks provided. A survey tool to register observations and questions regarding gruel preferences and consumption temperatures was employed. Data on drinking temperature of the participant‐selected gruels was registered with the same brand of food thermometer. The thermal flasks were gifted to participants as compensation for their time and effort. Results Study 1: Median serving temperature was 76.0°C (58.3–83.8°C) at 11 homes, with 82% exceeding 65.0°C, but consumption temperature was 59.2°C (47.7–65.7°C), with 18% above the critical level. Study 2: Median consumption‐temperature of gruels was 63.9°C (39.0 –80.0°C). A total of 33 of the 72 consumers (46%) began drinking with gruel temperatures above 65°C. Frequencies of >65°C consumption‐temperatures were: 11{rural}, 9{semi‐urban}, and 13{urban}, by respective site. In responses to qualitative questioning of the 24 participants, frequencies of gruel consumption‐temperature habitual preferences per the respective study sites were: “Hot” (11, 12, and 7, respectively); “Lukewarm” (12, 10, and 12, respectively); “Cold” (0, 2, and 3, respectively); and “Variable” (1, 0 and 2, respectively). Conclusion Although 42% reported preferring their gruel “hot” and 46% were able to tolerate consumption at a temperature above 65°C under our contrived testing conditions, usual thermal tissue exposure from this frequently ingested beverage remains unknown. Given the relation of temperature to cancer risk, more investigation is warranted.