Food commercialization in schools: analysis of the regulatory process in Brazil : análise

To identify and to describe the legal provisions that regulate the sale of food in Brazilian schools. Data were obtained from 96% of the federative units (25 States and the Federal District). 62 legal provisions were found: 60% current, 11% revoked and 29% draft bills. Current legislation was found in 67% of States: 100% of the States in the South, Southeast and Center-West regions, 56% in the Northeast and 43% in the North. Most of the legal provisions prohibit the sale of ultra-processed foods and encourage the sale of fruits and fresh foods in the public and private school network. Conclusion Progress is observed in the school food regulatory process in this country, considering its coverage in the States and in the public and private school network, but still restricted to the South, Southeast and Midwest regions.

On the websites, the search was carried out with the Sistema de Apoio ao Processo Legislativo (Legislative Process Support System), using the words: "school"; "canteen", "food", "school food", "caloric food" and "processed food", without filters of year of publication or type of legal provision. An electronic form (Google Forms) was further distributed, via institutional email from the Universidade de São Paulo, to the Legislative Assemblies of all the federation States, with questions regarding the existence of legal provisions on the marketing of food in the school setting and its details, type (law, resolution, decree, ordinance), legislation number and access link. The Legislative Support, Laws Bank, and the Legislative Library sectors were contacted by telephone if information was not found on the websites of it there was no response, or the e-mails returned due to an invalid address or were not answered. Out of the 27 federative units, only information from Amapá (State/capital) was not obtained.
Legal provisions regulating food sold in the school environment and referring to the quality of food sold, advertisements and food and nutrition education actions were included. Those that did not address any aspect of food marketing or that only regulated the food offered by the National School Feeding Program were excluded.
For analysis, legal provisions were grouped by geographic region (States/capitals and Federal District), in decreasing hierarchy of the legal provision and in ascending order of year of publication. The content of the material was synthesized, presented in Tables and the results were described using absolute and relative numbers.

R E S U L T S
The search identified 62 legal acts related to the regulation of food sales in Brazilian schools, with 60% in force (n=37), 11% revoked (n=7) and 29% in the form of bills (n=18). Data were obtained from 96% of the country's federative units (25 States/capital and Federal District). Chart 1 to 5 present a description of the legal provisions, both in force and revoked, by geographic region, States and/or capitals and the Federal District, year of publication, amendment, prohibited and Law 14,423 [16] -Provides that snack services in public/private educational units that serve basic education, located in the state, must comply with nutritional quality standards.
Prohibits: beverages with any alcohol content, candies, lollipops and chewing gum, soft drinks and artificial juices, processed snacks, fried snacks, processed popcorn. Additional: provide two types of seasonal fruits.
2005 Law 14,855 [17] -Provides for technical standards of nutritional quality, to be followed by cafeterias and similar establishments, installed in elementary and high schools, private and public. Note: ABIR-Brazilian Association of Soft Drinks and Non-Alcoholic Beverage Industries filed a direct action of unconstitutionality of the referred law, justified by: violating the guarantee of free commercialization of food products and the inexistence of any link between the consumption of soft drinks and human obesity, health risks, especially for children and adolescents.
Prohibits: Candies, lollipops, chewing gum, chocolates, sweets based on gum/caramels, artificial juices, soft drinks based on processed powders, soft drinks, snacks/processed popcorn, stuffed cookies, snacks/fried sweets, foods with more than 3g of fat/100 kcal of the product, foods with more than 160mg of sodium/100kcal of the product, foods containing artificial dyes/antioxidants, foods with no indication of origin, nutritional composition or expiration date. Additional: Snacks and drinks provided and sold in public and private schools in the State will be prepared according to nutritional quality standards consistent with the promotion of student health and the prevention of childhood obesity. Prohibits: Snacks, candies, chocolates, gum-based sweets, chewing gum, lollipop, caramel, processed powdered soft drinks, soft drinks, any food handled at school or in an unaccredited environment for food preparation, alcoholic beverages, foods with more than 3g of fat/100kcal of the product, with more than 160mg of sodium/100kcal of the product and foods containing artificial colorings, preservatives or antioxidants (observing the nutrition labeling available on the packaging), foods without labeling, nutritional composition and expiration date.
Decree 21,217 [32] -It prohibits, within the school units of the public education network, the purchase, manufacture, distribution and consumption of the products mentioned.
Prohibits: candy, gum-based sweets, chewing gum, lollipop, caramels, processed powdered soft drinks, alcoholic beverages, foods with high amounts of sodium or saturated fat and artificial colorings. Prohibits: Candies, lollipops, chewing gum, stuffed cookies, soft drinks and artificial juices, popcorn and processed snacks, fried foods in general, alcoholic beverages, processed foods whose percentage of calories from saturated fat exceeds 10% of total calories; foods in which hydrogenated vegetable fat is used; Prohibited foods extend to street vendors located around the school, advertising products listed as prohibited. Additional: offer, daily, at least one variety of seasonal fruit, in natura, whole/in pieces/in the form of juice; in fruit juices and dairy drinks, the addition of sugar is optional and will be offered for addition or not, according to consumer preference and not to exceed 2 sachets of 5g/200mL portion; insert nutritional education content into the pedagogical agenda. Prohibits: Candies, lollipops, chewing gum, stuffed cookies, soft drinks and artificial juices, processed snacks, fried foods in general, processed popcorn, alcoholic beverages, processed foods with a percentage of calories from saturated fat greater than 10% of total calories. Additional: offer at least 2 varieties of fresh seasonal fruit, whole/ in pieces/in the form of juice; juices and fruit crushes must be prepared without adding sugar/sweetener, which must be made by the consumer; add food education themes in the pedagogical content. Prohibits: acquisition of beverages with low nutritional value such as soft drinks and processed sugary drinks, beverages or concentrates based on guarana syrup or currant, ready-to-drink teas and other similar beverages, canned foods, sausages, sweets, compound foods (two or more packaged foods separately for joint consumption), semiready or ready-to-eat preparations or concentrated foods (powdered or dehydrated for reconstitution), with high amounts of sodium or saturated fat, with a maximum of 30% of the funds transferred to purchase school food, for the purchase of these foodstuffs.
2019 Law 11,196 [49] -Provides for the promotion of healthy eating and determines the exclusion of ultraprocessed and sugary foods in public and private schools within the State.
Prohibits: Ultra-processed and sugary foods. Prohibits: display of advertising posters that encourage the purchase and consumption of foods that contain trans fats, saturated fats, foods with no nutritional value and with excessive sugar and sodium content. Additional: display a menu, highlighting healthy and fresh foods, make available the varied sale of fruits, including seasonal ones, offered whole, in pieces or in the form of fruit crushes and juices. Prohibits: Savory pasta or puff pastry, fried foods in general, stuffed biscuits, snacks or processed popcorn, soft drinks and processed juices, processed or homemade sweets, candies, lollipops, chewing gum and the like, any food that is high in calories and rich in trans fat, as well as those with low nutritional content.

Maceió-AL (Capital)
1999 Law 4.897 [13] -Prohibits the installation of stalls and carts for the sale of foodstuffs in the vicinity of public and private schools in Maceió.
Prohibits: Installation of points of sale of consumable products by students, at a distance of less than 100m from the area of Teaching Establishments. Prohibits: candies, lollipops, chewing gum, snacks, stuffed cookies, chocolates, caramels, soda, popcorn and processed juices, alcoholic beverages, foods with more than 3g of fat/100kcal of the product, foods with more than 160mg of sodium/100kcal of the product, foods that contain artificial colorings, preservatives or antioxidants (observing the nutritional labeling available on the packages); advertise any product on the blacklist. The regional distribution showed that all States/capitals in the South, Southeast and Midwest regions had legal provisions in place; however, the same was not true in the other regions, where legislation was present in 5 of the 9 States/capitals of the Northeast region (56%) and 3 out of 7 in the North region (43%).

Rondônia-RD
More than half of the legal provisions in force were created in the first decade of the 2000s (n=21); however, until 2005 the laws instituted in the states and capitals of the South and Southeast regions stood out. As for coverage, 73% of the legislation referred to public and private educational institutions (n=27).
A general analysis shows that 57% (n=21) of current legal provisions prohibit the sale of a list of food, basically consisting of ultra-processed foods, such as candies, lollipops, chewing gum, chocolates, gum-based candies, caramels, artificial juices and soft drinks, cookies and stuffed biscuits, snacks and packaged popcorn and processed sausages. Some laws specify a maximum limit for nutrients such as fat, sugar and sodium in commercialized foods.
A quarter of the legal provisions highlights the offer of fresh season fruits and 16% prohibit food advertising. Only two mentioned the surroundings of the schools: Law nº 4,897, dated 1999, from Maceió (AL); this was the oldest date of a law issuance found in this study; the law prohibited the sale of food within a boundary of 100 meters from educational establishments [13]. However, despite the concern with the school environment in a broader way, the law was revoked in 2017; as well as the Federal District Law nº 3,695, dated 2005, which was repealed in 2007, but the new legislation dated 2013 continued to define the neighborhood of educational establishments as a school environment [14].
Regarding the Bills retrieved, two-thirds were issued by the State of São Paulo (n=12), dating back to 2002 (Bill nº 170) to 2016 [15]; four from the Northeast region, two in progress in Bahia (from 2003 and 2010) and two in Ceará (both from 2019); and two from the State of Mato Grosso, practically all with a list of prohibited foods, addressing the network of public and private schools for the fostering of healthy eating and prevention and control of obesity and other non-communicable chronic diseases.

D I S C U S S I O N
The findings of the present study showed that in Brazil, the process of regulating food marketing in the school environment is still under construction and is heterogeneous, considering its distribution by geographic regions. Although the first law was created in 1999 in Maceió, most of the current legal provisions, issued in the following years, until 2005, are concentrated in the South and Southeast regions, where all States have issued a specific legislation (Charts 1, 2, 3, 4 and 5).
This result reiterates what the analysis of Brazilian experiences with food regulation in the school environment in 2006 and other surveys carried out on popular and official electronic search sites found: coverage in 100% in the Southern region States and all capitals in the South, Southeast and Center-West regions [7,8,62]. Thus, despite the advance found in the level of coverage of Brazilian States/capitals (67%), the regulation is still restricted to the most developed geographic regions, which concentrate the greatest prevalence of overweight and obesity among adolescents [62,63] and the highest consumption of sweets and soft drinks, which could partially justify the institution of legal provisions to regulate the sale of food in the school setting [64].
However, this reflection leads to the question that arises about the impact of school feeding and nutrition policies on improving nutrition and reducing obesity. A systematic literature review carried out over the past decade showed that some policies were effective in improving the food environment and food intake in schools, but there was little impact assessment on body mass index [65].
Regarding the general aspects of the legislation, there was no change during the 20 years of the issuance of the first legislation, that is, the legal provisions do not consider the changes in the way of life of students and families, highlighted in the Food Guide for the Brazilian Population, which reinforces the need to involve the academic community and scientific evidence in the development and revision of regulations [66].
The Programa Nacional de Alimentação Escolar (PNAE, National School Feeding Program) has the Centros Colaboradores de Alimentação e Nutrição do Escolar (Collaborating Centers for School Feeding and Nutrition), which are linked to universities that carry out ongoing evaluations of the program and contribute to the regulatory process following recommendations and needs [67].
Besides the nutritional aspects of the food served in public schools, the PNAE encourages family farming and the use of organic food, being defined as a Healthy Public Policy that covers several areas that determine the health of the population, aspects that could be taken into account in the legislation that regulates the commercialization of food in the school setting [68,69].
Studies that assessed compliance with legislation show controversial results, but in general, they show that the laws do not prevent the sale of unhealthy foods. Only in Florianópolis, prohibited items were no longer sold or suffered a strong reduction in the 105 public and private schools that were evaluated five years after the institution of State Law nº 12,061 of 2001 [70]. In Belo Horizonte, the sale of foods with excess sugar, fat and sodium continued in 50% of schools, in an assessment carried out three years after the institution of Law nº 18,372, dated 2009, which prohibited the sale of low-nutritional snacks and beverages in State schools [71]. In Curitiba, practically all 111 canteens of public and private educational establishments sold foods prohibited by Law nº 14,855, dated 2005 [72]. In Porto Alegre, among the foods sold in canteens, the highest frequency was snacks, processed foods, stuffed biscuits, sweets, chocolate and soft drinks [73]. Thus, although 50% of the legal provisions establish a list of prohibited foods for sale, and two thirds of the country's federative units have appropriate legislation in place, there is no evidence that such legislation is effective in regulating the marketing of unhealthy products in the school setting.
Some changes in legal provisions are noteworthy. In the State of Mato Grosso, for example, Law nº 8,681, dated 2007 [42] which prohibited the sale of different foods was amended in the same year and began to restrict only the sale of alcoholic beverages and cigarettes in school canteens [43]. In the capital Cuiabá, Law nº 4,382, dated 2003 followed the same line of regulation as in Florianópolis, with a wide list of foods and beverages which sale was prohibited in schools, but a year later it was revoked, allowing the sale of sugary drinks and packed snacks [44,45]. In the State of Minas Gerais, the regulatory process began in 2004 with Law nº 15,072 which prohibited the sale of products with high levels of calories, saturated fat, trans fat, free sugar and salt, or with few nutrients, but only in 2018 a Decree was issued to regulate the 2004 Law, which had expanded the list of prohibited foods, but the Decree was suspended in 2019 for study and analysis [24].
The search on official websites raises the hypothesis that food industry associations and trade federations exert successful pressure on the legislative and executive powers, yet also find resistance. The State of Mato Grosso do Sul had Law nº 4,320, dated 2013 [46] revoked in the same year, following a lawsuit filed by the Federation of Commerce of the State of Mato Grosso do Sul, which also filed a lawsuit to revoke Law nº 4,992 of Campo Grande [47] which, however, was dismissed and the law remains in force. The same occurred in Florianópolis, where the Association of Food Industries filed a lawsuit in an attempt to suspend and revoke Law nº 5,853 [22], with the justification that it hinders the free trade guarantee. In Paraná, the Brazilian Soft Drinks and Non-Alcoholic Beverage Industries Association, in addition to the claim that the law hinders the guarantee of free trade, claimed that there was no relationship between soft drink consumption and obesity and health risks for children and adolescents, but the lawsuits were not considered grounded in the different appeals filed.
In addition to having encouraged changes and repeals in legal provisions, with success in some places that made the sale of unhealthy food items more flexible, the pressure exerted by such entities may also explain the high number of bills. This is a common problem in many countries when it comes to regulatory policies aimed at changing food habits for health promotion and obesity prevention [75]. Due to the economic contribution and influence in the generation of jobs, the industry lobby exerts a strong pressure on the government, causing legislations to match their interests [75,76].
In fact, a qualitative study carried out with members of different government departments in Australia revealed the difficult dialogue between government and industry, especially in the economic aspects; however, it revealed that the decisions taken regarding the legislation did not always favor the interests of the food industries [75].
The role of the community in supporting legislation should also be considered, as the growing concern with obesity makes the population aware and concerned and can contribute to the acceptance of the legal provisions that seek alternatives to control this problem [76][77].
The diversity in the websites of the State's legislative assemblies and the way in which legislation can be drafted and implemented in the different State and municipal secretariats made it difficult to search for existing legislation, which is a limitation of this study. Nevertheless, this study represents an advance in the information updating about existing legal provisions in the country.
In addition, the evidence found enhances the need to implement legislation at the national level, with a focus on the Escola Promotora da Saúde (Health Promoting School) to promote healthy eating and food and nutrition education.

C O N C L U S I O N
The results showed that in Brazil, the process of regulating food sales in the school setting is still under construction. Despite the fact that regulating laws began to be issued in 1999, 20 years later, only three quarters of the Brazilian States had enforced legal provisions, all of them in the States/capitals of the South, Southeast and Center-West regions.
Even with such regional disparities, the scenario shows an advance with regard to the legislation aimed at improving the food conditions in schools, an essential measure for the promotion of healthy eating and for the prevention and control of obesity. However, it is essential that legal provisions be effectively implemented, monitored and evaluated.
Although the legislation is necessary to favor healthy food consumption in schools, food and nutrition education and the dissemination of healthy eating within society stand out as fundamental for the promotion of health and adequate and healthy eating.