Ambiente alimentar do município de Rio Largo, Alagoas: disponibilidade física e custo de alimentos conforme grau de processamento

Abstract

The food environment (FE) represents the interaction between the physical space and various aspects related to the marketing of food, including multiple sociocultural, political, and individual issues, with availability and financial cost being two of the main influencing factors in the choice and acquisition of certain types of food. It is known that the modulation of eating behavior from conception to the end of life is caused by multiple exposures in a synergistic network that involves and articulates individual and collective biopsychosocial factors with the FE. Thus, the FE plays a fundamental role in the complex and ongoing construction of individuals' eating behavior and, consequently, in their health conditions. Therefore, this study aims to assess the physical and financial availability and the geospatial distribution of food in food retail outlets (FROs) in the municipality of Rio Largo, AL, according to the degree of food processing. This is a cross-sectional study with data from the "Health, Nutrition, and Child Development (SAND): a cohort study," with FE data collected between September 2017 and January 2018. For data collection from FROs, the adapted and validated version for the Brazilian population of the Nutrition Environment Measurement Survey for Stores (NEMS-S) scale was used. The method of obtaining data on the coordinates of each FRO in the city involved an audit of all streets, considered the gold standard in georeferencing studies. Descriptive statistical analyses (including means, medians, standard deviations, and interquartile ranges) and geospatial analyses (kernel density estimation and thematic map creation of FRO distribution in the city, considering the degree of food processing) were conducted using Stata 15 (StataCorp., College Station, TX, USA) and QGIS 3.16.9 (Open Source Geospatial Foundation), respectively. The statistical results revealed an FE with high availability of highly processed products (frequency of marketing of UltraProcessed Products - PUP - exceeding 80% in FROs in the city), with ultra-processed foods, on average, being nearly twice as cheap as healthy foods, considering the standard unit of sale. Price comparison analysis per 100 grams suggests that PUP are more expensive than fresh and minimally processed foods (INMP). Geospatial results show clusters of FROs that offer PUP throughout the entire urban area (especially in urban areas), while only a few businesses sell fresh and minimally processed foods. Thus, it can be concluded that the local FE has high physical and financial availability of PUP, along with low physical availability of INMP foods. These characteristics discourage healthy food choices by the population, necessitating greater public investment and planning to reverse the identified situation.