Disparidades no ambiente alimentar do consumidor de uma metrópole brasileira

Abstract

The consumer food environment is related to the availability, accessibility, quality and variety of foods available for purchase in a determined area. These factors could evidence health disparities present in vulnerable communities. The aim of the present study is to verify the availability, diversity, variety and quality of natural and ultra-processed foods in stores located in territories with different levels of health vulnerability in a Brazilian metropolis. This cross-sectional study used data from a previous study conducted in Belo Horizonte-MG. The data collection was carried out through an audit of the food-selling establishments in the area, using an adapted version of the ESAO-s instrument, which had been previously validated for the Brazilian context. Data were collected on the 10 most consumed fruits and 10 most consumed vegetables by the population in Belo Horizonte, in addition to the 5 most consumed ultra-processed foods. Territory vulnerability was measured with the Health Vulnerability Index (HVI), classified as low, medium and high/very high. We used descriptive analyses and regression models, adjusted by the area’s population. 248 stores were audited, among supermarkets, specialized fruits and vegetables stores and local stores. Low HVI areas had higher fruits (34.4% vs. 2.2%; p-value < 0.001) and vegetables (38.7% vs. 10.9%; p-value < 0.001) variety adequacy and better quality, when compared to medium and high/very high HVI areas. Supermarkets in low HVI areas had almost twice the prevalence of adequate vegetable variety (65.2% vs. 33.3% in high/very high HVI areas, p-value = 0.005). Adjusted by population, areas with high/very high HVI had lower odds of adequate fruit variety when compared to low HVI areas (OR = 0.06; CI 95% = 0.01 - 0.44; p-value = 0.006). We conclude that in Belo Horizonte-MG, disparities in the consumer food environment could lead to difficulties to access healthy food, especially to vulnerable populations. Urgent action should take place in food environments, through systematic interventions in policy-making.