Silva-Neto Luiz Gonzaga Ribeiro, Borges Camila Aparecida, Bueno Nassib Bezerra, Dos Santos Thays Lane Ferreira, de Menezes Risia Cristina Egito, de Menezes Toledo Florêncio Telma Maria
Programa de Pós-Graduação em Nutrição, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil.
Núcleo de Pesquisas Epidemiológicas em Nutrição e Saúde, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.
Nutr Bull. 2025 Mar;50(1):91-105. doi: 10.1111/nbu.12728. Epub 2024 Dec 31.
This study aimed to assess the association between community and consumer food environment (FE) measures and anaemia, overweight and abdominal obesity in mother-child dyads living in situations of social vulnerability. A cross-sectional study was carried out in 40 favelas in a capital city in the northeast of Brazil. The sample consisted of 1882 women and 665 children aged under 5 years. The community FE was assessed using a scale of perception of the availability of healthy food in the neighbourhood. Consumer FE was assessed by auditing 624 retail food stores using the AUDITNOVA instrument. This investigated various aspects of the food environment and evaluated the availability of 18 ultra-processed foods (UPF) most consumed by the Brazilian population available in these stores. The presence of overweight was assessed by measuring the weight and height of the mother and the child, and abdominal obesity was assessed by measuring the mother's waist circumference. The presence of anaemia in the mother and the child was assessed by measuring haemoglobin. Adjusted multilevel regression models were used to verify associations between the FE and malnutrition in mother-child dyads. Low perception of community FE was associated with higher risk of women being overweight (OR: 1.35; 95% CI: 1.05-1.73) and abdominally obese (OR: 1.38; 95% CI: 1.04-1.84); low health scores in food shops were associated with higher risk of abdominal obesity (OR: 1.35; 95% CI: 1.01-1.79) and anaemia (OR: 1.16; 95% CI: 1.02-1.98) in women and overweight in children (OR: 1.69; 95% CI: 1.05-2.73); and the high availability of UPF in retail shops was associated with increased odds of overweight (OR: 2.64; 95% CI: 1.61-4.33) and anaemia (OR: 2.11; 95% CI: 1.38-3.02) in children by 164% and 111%, respectively. It was observed that less healthy food environments are associated with greater chances of anaemia, overweight and abdominal obesity in mothers and children under 5 years in situations of social vulnerability in Brazil.
本研究旨在评估社区和消费者食品环境(FE)指标与生活在社会脆弱环境中的母婴二元组贫血、超重和腹型肥胖之间的关联。在巴西东北部一个首府城市的40个贫民窟开展了一项横断面研究。样本包括1882名女性和665名5岁以下儿童。社区FE通过邻里健康食品可得性感知量表进行评估。消费者FE通过使用AUDITNOVA工具对624家零售食品店进行审计来评估。该工具调查了食品环境的各个方面,并评估了这些商店中巴西人群最常消费的18种超加工食品(UPF)的可得性。通过测量母亲和孩子的体重和身高来评估超重情况,通过测量母亲的腰围来评估腹型肥胖。通过测量血红蛋白来评估母亲和孩子是否贫血。使用调整后的多水平回归模型来验证母婴二元组中FE与营养不良之间的关联。社区FE感知度低与女性超重风险较高(比值比:1.35;95%置信区间:1.05 - 1.73)和腹型肥胖风险较高(比值比:1.38;95%置信区间:1.04 - 1.84)相关;食品店健康得分低与女性腹型肥胖风险较高(比值比:1.35;95%置信区间:1.01 - 1.79)、贫血风险较高(比值比:1.16;95%置信区间:1.02 - 1.98)以及儿童超重风险较高(比值比:1.69;95%置信区间:1.05 - 2.73)相关;零售商店中UPF的高可得性分别使儿童超重几率增加164%、贫血几率增加111%(比值比:2.64;95%置信区间:1.61 - 4.33;比值比:2.11;95%置信区间:1.38 - 3.02)。研究发现,在巴西社会脆弱环境中,不健康的食品环境与5岁以下母亲和儿童患贫血、超重和腹型肥胖的几率增加有关。