Associations between food deserts, food swamps, and ultra-processed food intake in childhood.

objectiveThe aim of this study was to evaluate the association between retail food environments and consumption of ultra-processed foods in children.

methodsA cross-sectional study was conducted with 206 children aged 6-36 months who were followed up in primary health care. Consumption of ultra-processed foods was investigated using the intake marker form. Food deserts and swamps were identified using the Brazilian methodology proposed by the Food and Nutrition Security Intersectoral Chamber, and the density of healthy and unhealthy food outlets per 10,000 inhabitants was calculated. The associations between food environments and consumption of ultra-processed foods were estimated using binary logistic regression, yielding odds ratios (OR) and respective 95% confidence intervals (95%CI) from a generalized estimating equations model.

resultsUltra-processed foods were part of the diet in 60.18% of the children, with sweetened beverages being the most prevalent (42.22%). Living in sectors classified as food swamps was positively and independently associated with consumption of instant noodles, packaged snacks, or crackers (OR 2.71; 95%CI 1.19-6.16) and stuffed cookies/sweets/candies (OR 2.50; 95%CI 1.03-6.12).

conclusionsChildren living in food swamps were more likely to consume ultra-processed foods. The results indicate the need to promote environments that favor healthy food choices among families and children through adequate nutrition, nutrition education, and policies that regulate access to and the advertising of unhealthy foods.