Pessoa Milene Cristine, Mendes Larissa Loures, Gomes Crizian Saar, Martins Paula Andréa, Velasquez-Melendez Gustavo
Departamento de Nutrição e Saúde, Universidade Federal de Viçosa, Viçosa, Minas Gerais, Brazil.
Departamento de Nutrição, Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.
BMC Public Health. 2015 Oct 5;15:1012. doi: 10.1186/s12889-015-2277-1.
Environmental, social and individual factors influence eating patterns, which in turn affect the risk of many chronic diseases. This study aimed to estimate associations between environmental factors and the consumption of fruit and vegetables among adults in a Brazilian urban context.
Data from the surveillance system for risk factors for chronic diseases (VIGITEL) of Brazilian Ministry of Health were used. A cross-sectional telephone survey (VIGITEL - 2008-2010) was carried out with 5826 adults in the urban area of Belo Horizonte. Individual variables were collected. The frequency of fruit and vegetables consumption was assessed from number of servings, weekly frequency and an intake score was calculated. Georeferenced variables were used to characterize the food environment. The density of healthy food outlets (stores specialized in selling fruit and vegetables), unhealthy food outlets (bars, snack bars and food trucks/trailers) and the neighborhood family income were investigated and associated with fruit and vegetables intake score. Weighted multilevel linear regression was used to evaluate the associations between the environment variables and the fruit and vegetables intake score.
Higher fruit and vegetables intake scores were observed in neighborhoods with higher density of healthy food outlets and higher income. Lower scores were observed in neighborhood with higher density of unhealthy food outlets. These associations were adjusted by individual variables such as gender, age, physical activity, sugar sweetened beverages consumption, education level and smoking.
The food environment might explain some of the socioeconomic disparities with respect to healthy food intake and health outcomes. Healthy food stores are less common in socially disadvantaged neighborhoods, and therefore, healthy foods such as fruits and vegetables are less available or are of a lower quality in lower income areas.
Food environment characteristics and neighborhood socioeconomic level had significant associations with fruit and vegetable intake score. These are initial findings that require further investigation within the middle income world populations and the role of the environment with respect to both healthy and unhealthy food acquisition and intake.
环境、社会和个人因素会影响饮食模式，进而影响许多慢性病的风险。本研究旨在评估巴西城市环境中环境因素与成年人水果和蔬菜消费之间的关联。
使用了巴西卫生部慢性病危险因素监测系统（VIGITEL）的数据。对贝洛奥里藏特市区的5826名成年人进行了横断面电话调查（VIGITEL - 2008 - 2010）。收集了个体变量。根据食用份数、每周食用频率评估水果和蔬菜的消费频率，并计算摄入得分。使用地理参考变量来描述食物环境。调查了健康食品店（专门销售水果和蔬菜的商店）、不健康食品店（酒吧、小吃店和食品卡车/拖车）的密度以及邻里家庭收入，并将其与水果和蔬菜摄入得分相关联。采用加权多级线性回归来评估环境变量与水果和蔬菜摄入得分之间的关联。
在健康食品店密度较高且收入较高的社区，观察到水果和蔬菜摄入得分较高。在不健康食品店密度较高的社区，得分较低。这些关联通过性别、年龄、身体活动、含糖饮料消费、教育水平和吸烟等个体变量进行了调整。
食物环境可能解释了在健康食品摄入和健康结果方面的一些社会经济差异。健康食品店在社会弱势社区不太常见，因此，在低收入地区，水果和蔬菜等健康食品供应较少或质量较低。
食物环境特征和邻里社会经济水平与水果和蔬菜摄入得分有显著关联。这些是初步发现，需要在中等收入世界人群中进一步调查环境在获取和摄入健康与不健康食品方面的作用。
