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Background and objectivesThe consumption of unprocessed or minimally processed whole plant foods and of ultra-processed foods, as defined by the Nova food classification system, are associated in opposite ways with diet quality and risk of diseases. However, it can be difficult to evaluate and monitor the consumption of these foods in some contexts due to lack of resources and time constraints for data collection. This study aimed to describe two simple and easily derived diet quality scores and evaluate their performance in reflecting the dietary share of unprocessed or minimally processed whole plant foods and ultra-processed foods.MethodsA total of 812 adults (18 years old or older) answered the Nova24h screener, a 2-minute self-administered questionnaire that measures the consumption of a set of foods on the day before the interview. Food items included in this tool belong to two main groups of Nova classification: unprocessed or minimally processed whole plant foods (WPF, 33 food items) and ultra-processed foods (UPF, 23 food items). Two scores are obtained from this tool by summing the number of items checked - the Nova-WPF and the Nova-UPF. We compared the Nova-WPF and the Nova-UPF scores with the dietary intake (% of total energy) of all unprocessed or minimally processed whole plant foods and all ultra-processed foods, respectively, obtained through a full self-administered web-based 24-hour recall, applied on the same day. We evaluated the relationship between the approximate quintiles or intervals of each score and the corresponding % of energy intake by linear regression, and the agreement between the intervals of each score with the intervals of the corresponding % of energy intake, using the Prevalence-Adjusted and Bias-Adjusted Kappa (PABAK).ResultsApproximate quintiles of each score presented a direct and linear relationship with the corresponding % of energy intake (p-value for linear trend ConclusionsThese two scores performed well against the dietary share of unprocessed or minimally processed whole plant foods and ultra-processed foods in Brazil and can thus be used to evaluate and monitor diet quality.

This article aims to characterize the advertising appeals present in the food environment to market ultra-processed foods and to analyze the nutritional profile of these foods according to PAHO criteria and the presence of food additives. Cross-sectional study, with data audited in 20 small supermarkets in São Paulo. The INFORMAS protocol was used to classify the advertising messages. The foods were classified according to NOVA. The PAHO profile model was used to classify foods high in critical nutrients. Advertising patterns were identified by factor analysis. The association between patterns and food groups was investigated by linear regression. More than 95% of the ultraprocessed foods had at least 1 critical nutrient in excess. There was a positive association between the new brand, fun and advantageous pattern with snacks, ready-made products, dairy products and cookies; between the new brand and suggested use pattern with dairy products. The standardization of food advertising in small retail stores is associated with offering snacks, dairy products, ready-to-eat foods and cookies, products that exceed critical nutrients.O objetivo deste artigo é caracterizar os apelos publicitários presentes no ambiente alimentar para comercializar alimentos ultraprocessados e analisar o perfil nutricional desses alimentos segundo critérios da OPAS e presença de aditivos alimentares. Estudo transversal, com dados auditados em 20 pequenos supermercados de São Paulo. O protocolo INFORMAS foi utilizado para classificar as mensagens publicitárias. Os alimentos foram classificados segundo a NOVA. O perfil nutricional da OPAS foi utilizado para classificar os alimentos elevados em nutrientes críticos. Os padrões de publicidade foram identificados por análise fatorial. A associação entre os padrões e os grupos de alimentos foi investigada por regressão linear. Mais de 95% dos alimentos ultraprocessados tinham pelo menos um nutriente crítico em excesso. Verificou-se associação positiva entre o padrão nova marca, divertido e vantajoso com salgadinhos, produtos pré-prontos, lácteos e biscoitos, e entre o padrão nova marca e uso sugerido com lácteos. A padronização da publicidade de alimentos nos pequenos comércios varejistas está associada à oferta de salgadinhos, produtos lácteos, alimentos pré-prontos e biscoitos, produtos que excedem em nutrientes críticos.

Using group model building we developed a series of causal loop diagrams identifying the environmental impacts of ultra-processed food (UPF) systems, and underlying system drivers, which was subsequently validated against the peer-reviewed literature. The final conceptual model displays the commercial, biological and social drivers of the UPF system, and the impacts on environmental sub-systems including climate, land, water and waste. It displays complex interactions between various environmental impacts, demonstrating how changes to one component of the system could have flow-on effects on other components. Trade-offs and uncertainties are discussed. The model has a wide range of applications including informing the design of quantitative analyses, identifying research gaps and potential policy trade-offs resulting from a reduction of ultra-processed food production and consumption.

Objective:To analyse the extent and nature of food and beverage advertising on the three major Brazilian free-to-air television (TV) channels.Design:Cross-sectional study. A protocol developed for the International Network for Food and Obesity/Non-Communicable Diseases Research, Monitoring and Action Support was applied for data collection. A total of 432 h of TV programming was recorded from 06.00 to 24.00 hours, for eight non-consecutive and randomly selected days, in April 2018. All TV advertisements (ads) were analysed, and food-related ads were classified according to the NOVA classification system. Descriptive analyses were used to describe the number and type of ads, food categories and the distribution of ads throughout the day and time of the day.Setting:The three most popular free-to-air channels on Brazilian TV.Participants:The study did not involve human subjects.Results:In total, 14·2 % (n 1156 out of 7991) of ads were food related (858 were specific food items). Approximately 91 % of food items ads included ultra-processed food (UPF) products. The top three most promoted products were soft drinks, alcoholic beverages and fast-food meals. Alcoholic beverage ads were more frequently broadcast in the evening.Conclusion:The high risk of exposure of the Brazilian population to UPF ads should be considered a public health concern given the impact of unhealthy food advertising on people’s food choices and health.

OBJECTIVE: To estimate the carbon footprint of the Brazilian diet and of sociodemographic strata of this population. METHODS: Carbon footprint of the diet was estimated based on data from two 24-hour diet records, obtained in 2008 and 2009, from a probabilistic sample of the Brazilian population aged 10 years and over (n = 34,003) and on environmental impact coefficients of food and culinary preparations consumed in Brazil (gCO2e/kg). Means with 95% confidence intervals of food consumption (kcal/person/day) and the carbon footprint of the diet (gCO2e/person/day and in gCO2e/2,000kcal) were calculated for the population as a whole and for strata according to sex, age, income, education, macro-regions and Federative Unit. Linear regression models were used to identify significant differences (p < 0.05) in the dietary carbon footprint of different sociodemographic strata. RESULTS: The average carbon footprint of the Brazilian diet was 4,489gCO2e/person/day. It was higher for males, for the age group from 20 to 49 years and for the North and Midwest regions, and tended to increase with income and education. The pattern of association of footprint with sociodemographic variables did not change substantially with adjustment for differences in the amount of food consumed, except for a reduction in the relative excess of the footprint among males and an increase in the relative excess of the footprint in the Midwest region. CONCLUSION: The carbon footprint of the Brazilian diet exceeds by about 30% the footprint of the human diet, which could simultaneously meet the nutritional requirements of a healthy diet and the global goal of containing the increase in the planet's average temperature. The pattern of association of this footprint with sociodemographic variables can help identify priority targets for public actions aimed at reducing the environmental impacts of food consumption in Brazil. RESUMO OBJETIVO: Estimar a pegada de carbono da dieta brasileira e de estratos sociodemográficos dessa população. MÉTODOS: A pegada de carbono da dieta foi estimada com base nos dados de dois registros alimentares de 24 horas, obtidos em 2008 e 2009, de uma amostra probabilística da população brasileira com 10 ou mais anos de idade (n = 34.003) e em coeficientes de impacto ambiental de alimentos e preparações culinárias consumidos no Brasil (gCO2e/kg). Médias com intervalos de confiança de 95% do consumo alimentar (kcal/pessoa/dia) e da pegada de carbono da dieta (gCO2e/pessoa/dia e em gCO2e/2.000kcal) foram calculadas para o conjunto da população e para estratos segundo sexo, idade, renda, escolaridade, macrorregiões e Unidade Federativa. Modelos de regressão linear foram utilizados para identificar diferenças significativas (p < 0,05) na pegada de carbono da dieta de diferentes estratos sociodemográficos. RESULTADOS: A pegada média de carbono da dieta brasileira foi de 4.489gCO2e/pessoa/dia. Foi maior para o sexo masculino, para a faixa etária de 20 a 49 anos e para as regiões Norte e Centro-Oeste, e tendeu a aumentar com a renda e a escolaridade. O padrão de associação da pegada a variáveis sociodemográficas não se alterou substancialmente com o ajuste para diferenças na quantidade consumida de alimentos, exceto por uma redução no excesso relativo da pegada entre homens e pelo aumento no excesso relativo da pegada na região Centro-Oeste. CONCLUSÃO: A pegada de carbono da dieta brasileira excede em cerca de 30% a pegada da dieta humana que poderia atender, simultaneamente, os requisitos nutricionais de uma dieta saudável e a meta global de contenção do aumento da temperatura média do planeta. O padrão de associação dessa pegada às variáveis sociodemográficas pode auxiliar na identificação de alvos prioritários para ações públicas que visem a reduzir os impactos ambientais do consumo alimentar no Brasil.

The laterodorsal tegmental nucleus (LDTg) is a hindbrain cholinergic cell group thought to be involved in mechanisms of arousal and the control of midbrain dopamine cells. Nowadays, there is increasing evidence that LDTg is also engaged in mechanisms of anxiety/fear and promotion of emotional arousal under adverse conditions. Interestingly, LDTg appears to be connected with other regulators of aversive motivational states, including the lateral habenula (LHb), medial habenula (MHb), interpeduncular nucleus (IP), and median raphe nucleus (MnR). However, the circuitry between these structures has hitherto not been systematically investigated. Here, we placed injections of retrograde or anterograde tracers into LDTg, LHb, IP, and MnR. We also examined the transmitter phenotype of LDTg afferents to IP by combining retrograde tracing with immunofluorescence and in situ hybridization techniques. We found LHb inputs to LDTg mainly emerging from the medial division of the LHb (LHbM), which also receives axonal input from LDTg. The bidirectional connections between IP and LDTg displayed a lateralized organization, with LDTg inputs to IP being predominantly GABAergic or cholinergic and mainly directed to the contralateral IP. Moreover, we disclosed reciprocal LDTg connections with structures involved in the modulation of hippocampal theta rhythm including MnR, nucleus incertus, and supramammillary nucleus. Our findings indicate that the habenula is linked with LDTg either by direct reciprocal projections from/to LHbM or indirectly via the MHb-IP axis, supporting a functional role of LDTg in the regulation of aversive behaviors, and further characterizing LHb as a master controller of ascending brainstem state-setting modulatory projection systems.

In Brazil, any advertising strategies that take advantage of the child’s judgment or induce consumers to make harmful health choices are considered abusive. However, the efficacy of restrictions on their use on television (TV) food advertising remains poorly understood. This study analysed the extent and nature of abusive techniques according to national regulations and patterns in their use in food-related ads. Cross-sectional studyrecorded the programming of the three most popular TV channels (6 am–12 am), during eight non-consecutive days, in April 2018. Data collection was based on the INFORMAS protocol and two national regulations. Descriptive analyses were used to describe the types of food ads and abusive techniques used in ultra-processed products (UPP) ads. Principal component analysis was applied to identify patterns of abusive marketing techniques and to relate them to specific food groups. More than 90% of food ads included at least one UPP. Overall, 10.1% of UPP ads targeted children and 57.7% used some kind of abusive technique directed to children and adolescents. Most ads contained messages inducing harmful health choices did not present adequate and clear information about the product and contained more than one type of abusive technique. Four out of five patterns in the use of abusive techniques in UPP ads were specifically directed to children, and fast-food meals were associated with three out of five patterns. The high abusiveness of food advertising in UPP ads should be considered a public health concern given their impact on children’s food choices and health.

OBJECTIVE To describe the Nova score for the consumption of ultra-processed foods (UPF) and evaluate its potential in reflecting the dietary share of UPF in Brazil. METHODS This study was conducted in São Paulo with a convenience sample of 300 adults. Using a tablet, participants answered a 3-minute electronic self-report questionnaire on the consumption of 23 subgroups of UPF commonly consumed in Brazil, regarding the day prior the survey. Each participant score corresponded to the number of subgroups reported. The dietary share of UPF on the day prior to the survey, expressed as a percentage of total energy intake, was calculated based on data collected on a 30-minute complete 24-hour dietary recall administered by trained nutritionists. The association between the score and the dietary share of UPF was evaluated using linear regression models. The Pabak index was used to assess the agreement in participants’ classification according to the fifths of Nova score and the fifths of dietary share of UPF. RESULTS The average dietary share of UPF increased linearly and significantly with the increase of the Nova score for the consumption of ultra-processed foods. We found a substantial agreement in participants’ classification according to the fifths of the distribution of scores and the fifths of the dietary share of UPF (Pabak index = 0.67). Age was inversely associated with a relatively high frequency of UPF consumption (upper fifth of the distribution) for both score and dietary share of UPF. CONCLUSION The Nova score for the consumption of ultra-processed foods, obtained in a quick and practical manner, shows a good potential in reflecting the dietary share of UPF in Brazil. RESUMO OBJETIVO Descrever o escore Nova de consumo de alimentos ultraprocessados e avaliar seu potencial para refletir, no contexto brasileiro, a participação desses alimentos na dieta. MÉTODOS Estudo realizado na cidade de São Paulo com amostra de conveniência de 300 adultos, que responderam, em cerca de três minutos, em um tablet, a um questionário eletrônico de autorrelato sobre o consumo, no dia anterior, de 23 subgrupos de alimentos ultraprocessados comumente consumidos no Brasil. O escore de cada participante correspondeu ao número de subgrupos reportados. A participação de alimentos ultraprocessados no consumo alimentar do mesmo dia, expressa como percentual da ingestão total de energia, foi calculada por meio das respostas dos participantes a recordatório alimentar completo de 24 horas aplicado em cerca de 30 minutos por nutricionistas treinados. A associação entre o escore e a participação de ultraprocessados na dieta foi estudada por modelos de regressão linear. A concordância na classificação dos participantes segundo quintos do escore e quintos da participação de alimentos ultraprocessados na dieta foi avaliada pelo índice Pabak. RESULTADOS O percentual médio de participação de alimentos ultraprocessados na dieta aumentou linear e significativamente com o aumento do escore Nova de consumo de alimentos ultraprocessados. Observou-se concordância substancial na classificação dos participantes segundo quintos da distribuição do escore e quintos da distribuição do percentual de participação de alimentos ultraprocessados na dieta (índice Pabak = 0,67). Relação inversa da idade com a frequência de consumo relativamente elevado de alimentos ultraprocessados (quinto superior da distribuição) foi observada tanto para o escore quanto para a participação de alimentos ultraprocessados na dieta. CONCLUSÃO O escore Nova de consumo de alimentos ultraprocessados, obtido de forma rápida e prática, apresenta bom potencial para refletir, no contexto brasileiro, a participação desses alimentos na dieta.

This study investigated the use of persuasive advertising strategies in ultra-processed food (UPF) advertisements broadcast on the three most popular free-to-air television channels in Brazil. The programming of the selected channels was recorded on eight non-consecutive days from April 2018 (6:00 am–12:00 am). Information from each advertising piece was collected through an electronic questionnaire based on the INFORMAS protocol. Food products were classified according to the NOVA classification system. Marketing strategies were investigated in UPF advertisements and stratified into three groups. Principal component analysis was used to identify patterns of strategies. Linear regression models were employed to investigate the association between the patterns and food groups. In total, 90.77% of the food-related advertisements contained at least one UPF, and 96% of them included one or more persuasive advertising strategies. Five advertising patterns were identified and associated with the UPF food groups. The results showed that food advertising on Brazilian free television is marked by UPF, with the predominant use of persuasive advertising strategies, demonstrating a lack of enforcement of the current regulatory legislation in the country.

The supply chains of animal-sourced foods, particularly beef, pose risks to human and planetary health, threatening food sovereignty. These chains have been related to deforestation and the breaching of agricultural barriers, eradicating native forests and taking away space used to grow foods traditionally consumed by the Brazilian population, such as rice and beans. The present study aimed to quantify the land use (m2) and the food demand (kg) for beef cattle; and assess the variety of plant species mobilized to produce 1 kg of beef in the national livestock panorama. Food demands were calculated based on the nutritional requirements at each stage of the animal’s life cycles and for each of the main rearing systems practiced in the country. These estimates were then compared with the total area required to produce plant species mobilized in the supply chain. Our results demonstrate that the production of 1 kg of boneless meat from one ‘Animal Brazil’ mobilizes 33.63 m² over 50 months and demands 52 kg of food from just six plant species. Therefore, this study shed light on the inefficiency of the beef supply chain together with the onerous use of soil, which triggers low biodiversity.

Objective We aimed to establish equations for dimensioning of the physical area and determining the required number of food handlers in food services of schools and to compare them with reference equations. Methods It was visited 44 municipalities located in the states of São Paulo (n=36) and Rio de Janeiro (n=8) between 2013 and 2014. The physical area for school food services was evaluated using a measuring tape. For all food services, we calculated the Maximum Attendance Capacity, which is the sum of small and large meals served during the busiest shift. A validated checklist was used to evaluate food safety practices. Linear regression models were developed to establish the proposed equations. Results In total, we evaluated 205 school units. Based on the data, the following equations were established: Equation A: area of production=15.22+(maximum attendance capacity×0.02), which estimates the minimum area needed for a school food service; and Equation B: the number of food handlers=2.17+(maximum attendance capacity×0.002), to determine the minimum number of food handlers needed. These equations were established based on school food services that presented adequate food safety practices (i.e., low health risk). Conclusion It was established new equations for calculating the size of the physical area for school food services and the required number of food handlers. These new equations can be used as a starting point in management planning of a school food service.

ObjectiveTo investigate the association between neighbourhood food availability and the consumption of ready-to-consume products (RCP), either processed or ultra-processed, and unprocessed/minimally processed foods (UF-MPF) by children.DesignCross-sectional. 24 h Dietary recalls were collected from children from January 2010 to June 2011. Neighbourhood food availability data were collected from 672 food stores located within 500 m of participants’ homes, using an adapted and validated instrument. Neighbourhood-level socio-economic status (SES) was obtained by calculating the mean years of household head’s education level in each census tract covered by 500 m buffers. Foods that were consumed by children and/or available in the food stores were classified based on their degree of industrial processing. Multilevel random-effect models examined the association between neighbourhood food availability and children’s diets.SettingSantos, Brazil.SubjectsChildren (n513) under 10 years old (292 aged ResultsThe availability of RCP in food stores was associated with increased RCP consumption (PPPConclusionsResults suggest that food policies and interventions that aim to reduce RCP consumption in Santos and similar settings should focus on reducing the availability in food stores. The results also suggest that interventions should not only increase the availability of UF-MPF in lower-SES neighbourhoods, but should strive to make UF-MPF accessible within these environments.

The habenula is an epithalamic structure differentiated into two nuclear complexes, medial (MHb) and lateral habenula (LHb). Recently, MHb together with its primary target, the interpeduncular nucleus (IP), have been identified as major players in mediating the aversive effects of nicotine. However, structures downstream of the MHb-IP axis, including the median (MnR) and caudal dorsal raphe nucleus (DRC), may contribute to the behavioral effects of nicotine. The afferent and efferent connections of the IP have hitherto not been systematically investigated with sensitive tracers. Thus, we placed injections of retrograde or anterograde tracers into different IP subdivisions or the MnR and additionally examined the transmitter phenotype of major IP and MnR afferents by combining retrograde tract tracing with immunofluorescence and in situ hybridization techniques. Besides receiving inputs from MHb and also LHb, we found that IP is reciprocally interconnected mainly with midline structures, including the MnR/DRC, nucleus incertus, supramammillary nucleus, septum, and laterodorsal tegmental nucleus. The bidirectional connections between IP and MnR proved to be primarily GABAergic. Regarding a possible topography of IP outputs, all IP subnuclei gave rise to descending projections, whereas major ascending projections, including focal projections to ventral hippocampus, ventrolateral septum, and LHb originated from the dorsocaudal IP. Our findings indicate that IP is closely associated to a distributed network of midline structures that modulate hippocampal theta activity and forms a node linking MHb and LHb with this network, and the hippocampus. Moreover, they support a cardinal role of GABAergic IP/MnR interconnections in the behavioral response to nicotine.

OBJETIVO: Avaliar a disponibilidade de alimentos comercializados em relacao ao seu grau de processamento industrial e os tipos de comercios existentes nos perimetros de escolas de ensino fundamental. METODOS: O estudo teve delineamento transversal, e foram avaliados 82 comercios localizados a um raio de 500 metros de tres escolas publicas situadas em regioes distintas do municipio de Santos, que apresentam diferentes niveis socioeconomicos. Foram percorridas todas as ruas existentes nos perimetros das escolas, considerando-se um raio de 500 metros para delimitacao da area, tendo sido registradas as coordenadas geograficas e coletadas informacoes sobre os pontos de venda e sobre os alimentos comercializados, por meio de observacao e entrevista com os responsaveis pelo estabelecimento. Os alimentos encontrados foram classificados, em relacao ao seu grau de processamento industrial, em: alimentos ultraprocessados e alimentos minimamente processados. Para a avaliacao do grau de aglomeracao dos estabelecimentos nos perimetros das escolas, foram utilizados mapas de densidade de Kernel. RESULTADOS: Os pontos de vendas que ofertavam, em sua maioria, alimentos ultraprocessados estavam significativamente mais proximos das escolas do que aqueles que ofertavam maioria de alimentos com menor grau de processamento. Observou-se diferenca estatisticamente significativa entre a oferta desses alimentos nas diferentes categorias de comercios e entre as tres regioes avaliadas. CONCLUSOES: Os dados existentes neste trabalho evidenciam que as criancas que frequentam as tres escolas publicas avaliadas estao expostas a um ambiente que incentiva o consumo de alimentos ultraprocessados por meio de um acesso facilitado nos comercios investigados.

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP) Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) Introdução: Cada vez mais, tem-se investigado a influência do ambiente social e construído no estado de saúde dos indivíduos. Objetivo: Analisar as relações entre fatores ambientais relacionados ao acesso e disponibilidade de alimentos e o consumo de alimentos ultraprocessados por crianças menores de dez anos, residentes no município de Santos. Métodos: O estudo apresentou delineamento transversal e parcialmente ecológico, com um componente de base domiciliar e um componente ambiental. Nos domicílios investigou-se o consumo alimentar habitual de 528 crianças menores de dez anos e, no componente ambiental, realizou-se entrevista em 672 comércios. Os padrões de consumo alimentar segundo o processamento industrial dos alimentos ingeridos foram verificados pela análise de cluster. A análise de regressão avaliou a associação entre o consumo de alimentos ultraprocessados e o estado nutricional das crianças avaliadas. Para a investigação do efeito de variáveis ambientais no consumo de alimentos ultraprocessados utilizou-se a análise multinível. Resultados: Foram identificados dois agrupamentos de crianças que consumiam alimentos com diferentes graus de processamento industrial. A proporção de consumo de alimentos ultraprocessados associou-se positivamente com o IMC/idade das crianças avaliadas. Quanto maior a disponibilidade de alimentos ultraprocessados nos comércios localizados em um buffer de 500m do centroide do setor censitário, maior a proporção de consumo desses alimentos e menor a ingestão de alimentos minimamente processados pelas crianças avaliadas. Conclusão: O consumo de alimentos ultraprocessados tem impacto sobre o estado nutricional dos indivíduos e a oferta desses alimentos na vizinhança relaciona-se positivamente com a proporção de consumo desses alimentos. Introduction: Increasingly, we have investigated the effect of built and social environment in the state of health of individuals. Objective: To investigate the relationship between environmental factors related to access and food availability and consumption of processed foods by children under ten years old, living in the city of Santos. Methods: The study had a cross-sectional design, with a home-based component and an environmental component. In households investigated habitual food intake of 528 children under ten years and the environmental component, interviews took place in 672 trades. The food consumption patterns according to the industrial processing of food intake were performed by cluster analysis. Regression analysis examined the association between the consumption of ultra-processed foods and nutritional status of children. The multilevel analysis evaluated the relationship between the environmental variables and the consumption of ultra-processed foods. Results: We identified two groups of children who consumed foods with different degrees of processing. The proportion of consumption of ultra-processed foods was positively associated with BMI-for- age of the children. The greater availability of ultra-processed foods in the shops located in a buffer of 500m from the centroid of the census tract, the greater proportion of consumption of these foods and lower intake of minimally processed foods by the children evaluated. Conclusion: The consumption of ultra-processed foods has an impact on the nutritional status of individuals and the provision of food in the neighborhood relates positively with the proportion of these foods FAPESP: 2009/01361-1 FAPESP: 2010/04471-0

ObjectiveThe present study aimed to investigate the individual and family determinants of being overweight among children younger than 10 years of age.DesignCross-sectional survey. Direct data on children's age, food intake, physical activity, type of transportation used and anthropometric measurements, as well as the education level of the mothers, were collected by trained interviewers.SettingPopulation-based study in the city of Santos, Brazil.SubjectsA total of 531 children under 10 years of age (302 aged ResultsThe overall prevalence of overweight and obesity (BMI-for-age Z-score >1) was 35·4 % for children under 6 years and 38·9 % for children aged 6–10 years. The socio-economic status of the family was associated with being overweight for both age groups. Logistic regression analysis showed that the lower the socio-economic status, the higher the likelihood of being overweight, among both younger children (OR = 7·73; P = 0·02) and older children (OR = 1·98; P = 0·04). The use of active transportation was associated with a lower likelihood of being overweight, but only among younger children (OR = 1·70; P = 0·05).ConclusionsSocio-economic status seems to be an important individual-level determinant of overweight in children. Public policies should consider promoting the use of active transportation, as the results showed it to have a positive effect on reducing overweight issues. The high prevalence of overweight in younger children suggests that this age group should be a priority in health-promoting interventions.

Objective To validate an adapted instrument that assesses the nutritional environment of food stores in Brazilian urban areas. Methods The instrument measured aspects of food environment such as availability, prices, and quality. The Harvard Healthy Eating Pyramid and the degree of processing were used to define healthy foods. The sample included 44 food stores in 3 census tracts in the city of Santos. Inter-rater reliability and stability coefficient were obtained with measurements performed by different individuals at different times. Internal consistency and construct validity were assessed by Cronbach α and the known-groups comparison method, respectively. Results Inter-rater reliability was high. The mean intra-class correlation coefficient was 0.98 and the mean kappa was 0.77. Cronbach α values ranged from .68 to .93. Conclusions and Implications The instrument can be useful in the development of interventions to promote healthy eating through actions focused on healthy food availability in Brazilian communities.