Parental Perceived Travel Time to and Reported Use of Food Retailers in Association with School Children's Dietary Patterns

Neighborhood Availability and Use of Food, Physical Activity, and Social Services Facilities in Relation to Overweight and Obesity in Children and Adolescents

OBJECTIVE

To evaluate the association of a combined measure of availability and use of facilities from the food environment and overweight (including obesity) among schoolchildren, while taking into account the physical activity and social-assistance environments.

METHODS

Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to 14 years living in a southern Brazilian city (n = 2026). Multilevel analyses were performed with overweight as outcome and the food environment as main exposure. Models were adjusted for the physical activity and social-assistance environments, as well as individual and other residential neighborhood characteristics.

RESULTS

Greater availability of restaurants around the home was associated with higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85). Stronger associations were found for schoolchildren reporting to use restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained significant after adjusting for the presence of other food retailers. Schoolchildren who had social-assistance facilities around their homes, but reported not to use them, showed consistently higher odds of being overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who had these facilities near home and used them. The physical activity environment was not associated with the outcome.

CONCLUSIONS

Availability and use of the food and social-assistance environments were significantly associated with overweight (including obesity) among the schoolchildren. Future research should consider the use of environmental facilities in combination to their geographical availability. Our results highlight the need for policies that limit the access to obesogenic food outlets by children and adolescents.

Body image and association with BMI, and purgative behaviours for weight control in adolescents aged 11-14 years

We aimed to evaluate the association of overweight/obesity based in BMI and purgative behaviours with body image (BI). Methods: Cross-sectional study, with probabilistic sample of 976 adolescents, aged 11-14 years, from the city of Florianópolis, Brazil. Multivariate analyses were performed. Overweight (including obesity) and four variables related to purgative methods for body weight control or eating behaviour were evaluated as outcomes, while BI satisfaction was the primary independent variable in each model. Models were controlled for age, sex, type of school (public or private), intake of fruit and vegetables, number of daily meals, and physical activity scores levels. A total of 31·4 % of adolescents wanted to enlarge their silhouette and 45·6 % wanted to reduce it. Among overweight/obese adolescents, 9·6 % were satisfied with their bodies, while 89·8 % wanted to reduce it, while among the not overweight/obese adolescents, 45·4 % wanted to enlarge their silhouette (P < 0·001). Multivariate analysis showed that the odds for overweight/obesity is higher among adolescents who wanted to reduce their silhouette (OR = 11·20; 95 % CI = 5·55, 22·58). Adolescents who want to reduce their silhouette are more likely to use diuretics (OR = 3·08; CI = 1·78, 5·32) and to use laxatives (OR = 2·10; CI = 1·20, 3·68). A significant association was also found between dissatisfaction with BI and overeating (among those who want to enlarge their silhouette: OR = 1·78; CI = 1·12, 2·85 and among those who want to reduce their silhouette: OR = 1·81; CI = 1·03, 3·19). Conclusion: BI dissatisfaction was associated with overweight/obesity, as well with overeating, and the use of purgative methods.

The influence of the urban food environment on diet, nutrition and health outcomes in low-income and middle-income countries: a systematic review

INTRODUCTION

Diet and nutrition are leading causes of global morbidity and mortality. Our study aimed to identify and synthesise evidence on the association between food environment characteristics and diet, nutrition and health outcomes in low-income and middle-income countries (LMICs), relevant to urban settings, to support development and implementation of appropriate interventions.

METHODS

We conducted a comprehensive search of 9 databases from 1 January 2000 to 16 September 2020 with no language restrictions. We included original peer-reviewed observational studies, intervention studies or natural experiments conducted in at least one urban LMIC setting and reporting a quantitative association between a characteristic of the food environment and a diet, nutrition or health outcome. Study selection was done independently in duplicate. Data extraction and quality appraisal using the National Heart Lung and Blood Institute checklists were completed based on published reports using a prepiloted form on Covidence. Data were synthesised narratively.

RESULTS

74 studies met eligibility criteria. Consistent evidence reported an association between availability characteristics in the neighbourhood food environment and dietary behaviour (14 studies, 10 rated as good quality), while the balance of evidence suggested an association with health or nutrition outcomes (17 of 24 relevant studies). We also found a balance of evidence that accessibility to food in the neighbourhood environment was associated with diet (10 of 11 studies) although evidence of an association with health outcomes was contradictory. Evidence on other neighbourhood food environment characteristics was sparse and mixed. Availability in the school food environment was also found to be associated with relevant outcomes. Studies investigating our other primary outcomes in observational studies of the school food environment were sparse, but most interventional studies were situated in schools. We found very little evidence on how workplace and home food environments are associated with relevant outcomes. This is a substantial evidence gap.

CONCLUSION

'Zoning' or 'healthy food cart' interventions to alter food availability may be appropriate in urban LMIC.

PROSPERO REGISTRATION NUMBER

CRD42020207475.

Environmental Influences on Food Behaviour

The ubiquitous presence of food cues in our modern environment is believed to contribute to the rising trends in overconsumption and associated obesity observed over the last few decades [...].