The food environment of Brazilian public and private schools

This study’s aim was to characterize the food environment of Brazilian public and private schools. This was a national school-based cross-sectional study with 1,247 schools - among which 81.09% were public and 18.91% were private - in 124 Brazilian municipalities. The data originated from the Questionnaire on Aspects of the School Environment, used in the Study of Cardiovascular Risk in Adolescents (ERICA) in 2013 and 2014. Data analysis was conducted in 2017. The chi-square test was used to compare proportions. A greater proportion of public schools offered school meals (98.15%) in comparison to private schools (8.07%) (p < 0.001). The internal sale of food and beverages was more prevalent in private schools (97.75% vs. 45.06%, p < 0.001). Also, sale and advertisement of processed and ultra-processed foods (sodas, cookies, savory snacks, sandwiches and pizza), as well as the presence of vending machines for industrialized products (18.02% vs. 4%) (p < 0.001) were more common in private schools. Street vendors at the school gate or surroundings were identified in 41.32% of the public schools and 47.75% of the private schools (p > 0.05). These findings reveal the predominance of obesogenic environments mainly in private schools, and can contribute to the design of Brazilian public policies to promote a healthy school food environment.

Keywords:
Feeding; Adolescent; Schools

Variables	Public		Private		p-value *
Variables	%	95%CI	%	95%CI
Offers school meal	98.1	97.2-98.9	8.0	4.4-11.6	< 0.001
Has beverage and food vending machine	5.5	4.1-6.9	14.4	9.7-19.0	< 0.001
Sale of food in school	45.0	41.9-48.1	97.7	95.7-99.7	< 0.001
Sale of confectioneries in school	35.7	32.6-38.7	79.7	73.2-84.1	< 0.001
Sale of sweet biscuits and savory snacks in school	32.7	29.7-35.7	76.1	70.4-81.7	< 0.001
Sale of soda in school	34.9	31.9-37.9	75.2	69.5-80.9	< 0.001
Sale of fried or baked savory snacks	40.6	37.5-43.7	93.2	89.9-96.5	< 0.001
Sale of sandwiches in school	25.5	22.8-28.3	85.1	80.4-89.8	< 0.001
Sale of pizza in school	15.2	13.0-17.5	73.7	67.9-79.6	< 0.001
Presence of processed food advertisement	4.7	3.3-6.0	18.9	13.7-24.1	< 0.001
Presence of a well-structured cafeteria	59.6	56.5-62.7	54.0	47.4-60.6	0.125
Presence of street vendors at school gate or surroundings	58.6	55.5-61.7	47.7	45.6-58.8	0.081

Variables	North		Northeast		Southeast		South		Central		p-value *
Variables	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Offers school meal	98.4	96.7-100.0	96.7	94.6-98.8	98.2	96.5-99.9	100.0	-	98.5	96.6-100.0	0.234
Has beverage and food vending machine	11.1	6.6-15.5	2.5	0.6-4.3	6.0	2.9-9.2	1.6	0.6-3.8	6.3	2.2-10.3	< 0.001
Sale of food in school	59.0	52.1-65.9	26.2	21.0-31.4	44.3	37.8-50.8	51.6	42.6-60.5	57.7	49.5-65.9	< 0.001
Sale of confectioneries in school	51.0	43.9-58.0	23.7	18.7-28.7	36.5	30.2-42.7	25.0	17.2-32.7	45.7	37.8-54.0	< 0.001
Sale of sweet biscuits and savory snacks in school	48.2	41.1-55.2	20.5	15.7-25.2	33.0	26.9-39.1	33.0	24.6-41.4	34.5	26.5-42.4	< 0.001
Sale of soda in school	50.5	43.4-57.5	23.0	18.0-28.0	35.2	28.9-41.4	25.0	17.2-32.7	45.0	36.7-53.3	< 0.001
Sale of fried or baked savory snacks in school	54.5	47.5-61.5	23.7	18.7-28.7	38.8	32.5-45.2	47.5	38.6-56.4	51.4	43.0-59.7	< 0.001
Sale of sandwiches in school	29.0	22.6-35.4	16.5	12.1-20.9	31.0	24.9-37.0	33.8	25.4-42.3	22.5	15.5-29.4	< 0.001
Sale of pizza in school	20.4	14.7-26.1	11.8	8.0-15.6	6.5	3.3-9.7	33.0	24.6-41.4	13.3	7.7-19.0	< 0.001
Presence of processed food advertisement in school	8.0	4.2-11.9	3.9	1.6-6.2	0.8	0.0-2.0	1.6	0.0-3.8	10.5	5.4-15.6	< 0.001
Presence of a well-structured cafeteria	56.0	49.0-73.0	48.2	42.2-54.1	83.4	78.6-88.3	77.4	69.9-84.8	33.1	25.2-40.9	< 0.001
Presence of street vendors at the gate and surroundings of the school	70.1	64.3-77.1	64.3	58.7-70.0	57.8	51.4-64.3	36.5	27.9-45.2	51.0	42.7-59.4	< 0.001

Variables	North		Northeast		Southeast		South		Central		p-value *
Variables	%	95%CI	%	95%CI	%	95%CI	%	95%CI	%	95%CI
Offers school meal	4.0	0.0-12.2	5.8	0.7-10.8	9.8	1.3-18.2	23.0	5.7-40.4	2.8	0.0-8.6	0.032
Has beverage and food vending machine	20.0	3.8-36.8	23.5	14.3-32.7	7.8	0.2-15.4	3.8	0.0-11.76	5.7	0.0-13.8	0.013
Sale of food in school	100.0	-	98.8	96.4-100.0	94.1	87.4-100.0	100.0	-	97.1	91.3-100.0	0.316
Sale of confectioneries in school	88.0	74.3-100.0	90.4	84.0-96.8	70.5	57.6-83.5	50.0	29.4-70.5	77.1	62.5-91.7	< 0.001
Sale of sweet biscuits and savory snacks in school	76.0	58.0-93.9	83.5	75.4-91.5	76.4	64.4-88.5	73.0	54.8-91.3	60.0	42.9-77.0	0.103
Sale of soda in school	92.0	80.5-100.0	89.4	82.7-96.0	68.6	55.4-81.8	30.7	11.7-49.7	71.4	55.6-87.1	< 0.001
Sale of fried or baked savory snacks in school	100.0	-	94.1	89.0-99.0	92.1	84.5-99.7	92.3	81.3-100.0	88.5	77.4-99.6	0.515
Sale of sandwiches in school	92.0	80.5-100.0	87.0	79.7-94.3	90.2	81.7-98.6	80.7	64.5-97.0	71.4	55.6-87.1	0.099
Sale of pizza in school	80.0	63.1-96.8	78.5	69.6-87.5	70.6	57.6-83.5	76.9	59.5-94.2	60.0	42.9-77.0	0.255
Presence of processed food advertisement in school	32.0	12.3-51.6	23.5	14.3-32.7	13.7	3.9-23.5	0.0	-	20.0	0.6-33.9	0.027
Presence of a well-structured cafeteria	44.0	23.0-64.0	60.0	49.3-70.6	50.9	36.7-65.1	73.0	54.8-91.3	37.1	20.3-53.9	0.037
Presence of street vendors at the gate and surroundings of the school	56.0	35.0-76.9	48.2	37.3-59.0	56.8	42.7-70.9	34.6	15.0-54.2	65.7	49.1-82.2	0.141

Escola Nacional de Saúde Pública Sergio Arouca, Fundação Oswaldo Cruz Rua Leopoldo Bulhões, 1480 , 21041-210 Rio de Janeiro RJ Brazil, Tel.:+55 21 2598-2511, Fax: +55 21 2598-2737 / +55 21 2598-2514 - Rio de Janeiro - RJ - Brazil
E-mail: cadernos@ensp.fiocruz.br

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[1] Correspondence A. S. Carmo Escola de Enfermagem, Universidade Federal de Minas Gerais. Av. Prof. Alfredo Balena 190, Belo Horizonte, MG 30130-100, Brasil. arienecarmo@gmail.com