The food retail environment around schools in a low-income Brazilian city: a street audit evaluation

Abstract

This cross-sectional study evaluated the retail food environment (FE) around early childhood education centers (ECEC) in Rio Largo/AL, Brazil. Food retail outlets (FRO) were identified through a city street survey and audited using the Brazilian version of the Nutrition Environment Measurement Survey for Stores (NEMS-S). The Department of Education provided the ECEC's addresses, which were validated and geocoded (n=21). Schools' surroundings were defined by 400- and 800-meter buffers. The FE was analyzed using the healthy food availability index (HFAI), average distance between FRO and ECEC, and distribution and density of FRO according to the predominant type of food marketed (healthy, mixed, and unhealthy). Respectively, 332 (57.7%) and 505 (87.8%) FRO were identified in the 400- and 800-meter buffers. On average, 23 (400 m) and 54 (800 m) FRO were around schools, where ~60% were unhealthy (clustered throughout the city). The HFAI was very low for both buffers (400m: -1 points [IQR -6; 10]; 800m: -2 points [IQR -6; 10]). In conclusion, the city does not offer a supportive community food environment for children to develop and maintain healthy eating patterns.