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OBJECTIVE: To characterize the food environment in schools that participated in the Study of Cardiovascular Risks in Adolescents (ERICA) and to identify individual and contextual factors associated with hypertension and obesity. DESIGN: National school-based survey. SETTING: Blood pressure, weight and height were measured, and characteristics of the schools were obtained in interviews with the principals. For each outcome, multilevel models of mixed effects were applied by logistic regression. PARTICIPANTS: School-going adolescents aged 12-17 years. RESULTS: A total of 73 399 adolescents were evaluated. The prevalence of hypertension was 9·6 (95 % CI 9·0, 10·3) % and that of obesity was 8·4 (95 % CI 7·9, 8·9) %. Approximately 50 % of the adolescents were able to purchase food at school and in its immediate vicinity and 82 % had access to no-charge meals through Brazil's National School Feeding Program. In the adjusted analysis, hypertension was associated (OR; 95 % CI) with the consumption of meals prepared on the school premises (0·79; 0·69, 0·92), the sale of food in the school's immediate vicinity (0·67; 0·48, 0·95) and the purchase of food in the school cafeteria (1·29; 1·11, 1·49). It was observed that there were lower odds of obesity among students who were offered meals prepared on the school premises (0·68; 0·54, 0·87). CONCLUSIONS: High frequency of sales of ultra-processed foods in schools was identified. Contextual and individual characteristics in the school food environment were associated with hypertension and obesity, pointing to the need for regulation and supervision of these spaces.

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OBJECTIVE: To identify examples of the 'corporate political activity' (CPA) of the industry producing and selling ultra-processed food and drink products (UPP) in Latin America and the Caribbean. DESIGN: Searches were conducted on the national websites and social media accounts of large industry actors. Coding was deductive and based on a framework for classifying the CPA of the food industry. SETTING: Fifteen countries in Latin America and the Caribbean.ParticipantsTwelve members of the International Food and Beverage Alliance (IFBA) and major trade associations and chambers of commerce in the region. RESULTS: During the current pilot study, more than 200 examples of CPA were found in Latin America and the Caribbean. The UPP industry lobbied governments during the development of national health policies. UPP companies tried to build alliances with health professionals, but also with communities where they operated and with policy makers. In addition, the UPP industry fought against regulation in court and proposed weaker alternatives to public health policies, such as self-regulation. CONCLUSIONS: Food systems in low- and middle-income countries, including in Latin America and the Caribbean, are increasingly penetrated by the UPP industry. These countries are at risk of being influenced by the CPA strategies described in the present study. There is a need to further identify, monitor and evaluate the impact of these CPA strategies on public health policies and public opinion in the region, in order to develop mechanisms to effectively prevent such interference.

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ABSTRACT BACKGROUND: Access to food retailers is an environmental determinant that influences what people consume. This study aimed to test the association between the use of food outlets and schoolchildren's intake of minimally processed and ultra-processed foods. DESIGN AND SETTING: This was a cross-sectional study conducted in public and private schools in Florianópolis, state of Santa Catarina, southern Brazil, from September 2012 to June 2013. METHODS: The sample consisted of randomly selected clusters of schoolchildren aged 7 to 14 years, who were attending 30 schools. Parents or guardians provided socioeconomic and demographic data and answered questions about use of food outlets. Dietary intake was surveyed using a dietary recall questionnaire based on the previous day's intake. The foods or food groups were classified according to the level of processing. Negative binomial regression was used for data analysis. RESULTS: We included 2,195 schoolchildren in the study. We found that buying foods from snack bars or fast-food outlets was associated with the intake frequency of ultra-processed foods among 11-14 years old in an adjusted model (incidence rate ratio, IRR: 1.11; 95% confidence interval, CI: 1.01;1.23). Use of butchers was associated with the intake frequency of unprocessed/minimally processed foods among children 11-14 years old in the crude model (IRR: 1.11; 95% CI: 1.01;1.22) and in the adjusted model (IRR: 1.11; 95% CI: 1.06;1.17). CONCLUSIONS: Use of butchers was associated with higher intake of unprocessed/minimally processed foods while use of snack bars or fast-food outlets may have a negative impact on schoolchildren's dietary habits.

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BACKGROUND: Access to food retailers is an environmental determinant that influences what people consume. This study aimed to test the association between the use of food outlets and schoolchildren's intake of minimally processed and ultra-processed foods. DESIGN AND SETTING: This was a cross-sectional study conducted in public and private schools in Florianópolis, state of Santa Catarina, southern Brazil, from September 2012 to June 2013. METHODS: The sample consisted of randomly selected clusters of schoolchildren aged 7 to 14 years, who were attending 30 schools. Parents or guardians provided socioeconomic and demographic data and answered questions about use of food outlets. Dietary intake was surveyed using a dietary recall questionnaire based on the previous day's intake. The foods or food groups were classified according to the level of processing. Negative binomial regression was used for data analysis. RESULTS: We included 2,195 schoolchildren in the study. We found that buying foods from snack bars or fast-food outlets was associated with the intake frequency of ultra-processed foods among 11-14 years old in an adjusted model (incidence rate ratio, IRR: 1.11; 95% confidence interval, CI: 1.01;1.23). Use of butchers was associated with the intake frequency of unprocessed/minimally processed foods among children 11-14 years old in the crude model (IRR: 1.11; 95% CI: 1.01;1.22) and in the adjusted model (IRR: 1.11; 95% CI: 1.06;1.17). CONCLUSIONS: Use of butchers was associated with higher intake of unprocessed/minimally processed foods while use of snack bars or fast-food outlets may have a negative impact on schoolchildren's dietary habits.

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The research aimed to identify the current feed of Xerente people in Indian villages Porteira and Funil in the city of Tocantinia / TO. It was used a qualitative ethnographic approach. Conducted from September 2013 to August 2014. The data were presented in a diary, through participant observation of food practices with the guidance of a script. A process of dietary change that permeates the culture of this people is taking place. Factors such as the deficit in the planting gardens, the recent arrival of energy, and therefore the technology has allowed access to processed foods. But some families still maintain the farming of cassava, yam, and beans. The main animals that are hunted in the village are peccary, deer and armadillo. It was possible to point which foods are inserted in the Xerente feed and factors related to this situation. A pesquisa objetivou identificar a alimentação atual do povo Xerente, nas aldeias indígenas Porteira e Funil, no município de Tocantínia / TO. Utilizou-se uma abordagem etnográfica qualitativa. Realizada entre setembro de 2013 a agosto de 2014. Os dados foram descritos através de um diário de campo, por meio da observação das práticas alimentares com a orientação de um roteiro. Está ocorrendo um processo de mudança alimentar na cultura deste povo. Fatores como o déficit no plantio das roças, a chegada da energia, e consequentemente a tecnologia, permitiu o acesso a alimentos industrializados. Mas algumas famílias ainda mantem o cultivo de mandioca, inhame, feijão andu. Os principais animais que são caçados na aldeia são caititu, veado e tatu. Foi possível encontrar a presença de alimentos industrializados inseridos na alimentação do Xerente e isso tem provocado alterações nos hábitos desse povo.

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INTRODUCTION: The childhood obesity epidemic is a global concern. There is limited evidence in Mexico linking the local food environment to obesity. The purpose of this study is to describe the links between the local food environment around elementary schools and schoolchildren's BMI in two Mexican cities. METHODS: Cross-sectional surveys were conducted in 60 elementary schools in two Mexican cities (i.e., Cuernavaca and Guadalajara) in 2012-2013. Anthropometric measurements on schoolchildren were collected, as well as environmental direct audits and observations in a 100-m buffer around schools. Children's BMI was evaluated according to WHO-recommended procedures. In BMI models, the explanatory variable was the number of retail food sources. These models were adjusted for child's characteristics, schools' socioeconomic background, compliance with federal guidelines concerning unhealthy foods within schools' facilities, and corresponding city. Analysis was conducted in 2014. RESULTS: The number of mobile food vendors was higher around public schools than outside private schools (p<0.05). Linear regression procedures showed a significant positive statistical association between children's BMI and the number of mobile food vendors around schools. Schoolchildren from the highest tertile of mobile food vendors showed 6.8% higher BMI units than those from the lowest tertile. Children attending schools within the highest tertile of food stores also had 4.7% higher BMI units than children from schools in the lowest tertile. CONCLUSIONS: Health policy in Mexico should target the obesogenic environment surrounding elementary schools, where children may be more exposed to unhealthy foods.

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Objective To measure the effect of socioeconomic variables on the prevalence of obesity. Factors such as income level, urbanization, incorporation of women into the labor market and access to unhealthy foods are considered in this paper. Method Econometric estimates of the proportion of obese men and women by country were calculated using models based on panel data and quantile regressions, with data from 192 countries for the period 2002-2005.Levels of per capita income, urbanization, income/big mac ratio price and labor indicators for female population were considered as explanatory variables. Results Factors that have influence over obesity in adults differ between men and women; accessibility to fast food is related to male obesity, while the employment mode causes higher rates in women. The underlying socioeconomic factors for obesity are also different depending on the magnitude of this problem in each country; in countries with low prevalence, a greater level of income favor the transition to obesogenic habits, while a higher income level mitigates the problem in those countries with high rates of obesity. Discussion Identifying the socio-economic causes of the significant increase in the prevalence of obesity is essential for the implementation of effective strategies for prevention, since this condition not only affects the quality of life of those who suffer from it but also puts pressure on health systems due to the treatment costs of associated diseases.

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