ArticlePublic health nutrition2024
Urban school neighbourhoods dominated by unhealthy food retailers and advertisements in Greater Tunis: a geospatial study in the midst of the nutrition transition.
Article in Public health nutrition, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 4 citations in OpenAlex.
- Obesogenicity of food in the informal food retail environment of low- and middle-income countries: a systematic review.BMJ global health · 2025Pooled it
- Association between the geospatial school food environment and nutritional outcomes among school children: a systematic review.European journal of clinical nutrition · 2026Review
- Nutrition transitions, obesity and T2DM in the Middle East and North Africa.Nature reviews. Endocrinology · 2026Review
- Food Is Always Close By: An Assessment of the Healthiness of the Adolescent Home and School Food Environments in Northern Vietnam.Current developments in nutrition · 2026Article
- Public School Teachers' Nutrition Knowledge and Perceptions of the School Food Environment in Kazakhstan.Nutrients · 2026Article
- Exploring the barriers and facilitators of nutrition and dietary intake among school-aged children in the urban low-income setting of Addis Ababa.Nutrition research and practice · 2025Article
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Authors and funding
12 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveFood environments are a major determinant of children's nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia - an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity.
designIn this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network buffer of each school. Retailers and advertisement sets were categorised as healthy or unhealthy according to a NOVA-based classification. Associations between school characteristics and retailers or advertisement sets were explored using multinomial regression models.
settingGreater Tunis, Tunisia.
participantsRandom sample of fifty (thirty-five public and fifteen private) primary schools.
resultsOverall, 3621 food retailers and 2098 advertisement sets were mapped. About two-thirds of retailers and advertisement sets were labelled as unhealthy. Most retailers were traditional corner stores (22 %) and only 6 % were fruit and vegetable markets. The prevailing food group promoted was carbonated and sugar-sweetened beverages (22 %). The proportion of unhealthy retailers was significantly higher in the richest
conclusionsSchool neighbourhood food environments included predominantly unhealthy retailers and advertisements. Mapping of LMIC food environments is crucial to document the impact of the nutrition transition on children's nutritional status. This will inform policies and interventions to curb the emergent childhood obesity epidemic.
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