Neighborhood environment is associated with unhealthy food intake in a Brazilian urban area

Abstract

Unhealthy food intake is one of the main risk factors for morbidity and mortality for non-communicable diseases (NCDs), and is associated with multiple factors, including the neighborhood environment. The present study aimed to examine the association between the neighborhood context and unhealthy food intake in adults. This is a cross-sectional study, carried out in Belo Horizonte, Brazil. This study used the database of Surveillance System for Risk and Protective Factors for Chronic Diseases by Telephone Survey (Vigitel), which was georeferenced and linked to a database with information on the physical and social realities of a neighborhood context. The administrative boundary of the basic health units (ABBHU) was used as a neighborhood unit. Unhealthy food intake was assessed by the regular consumption of meat with excess fat, soft drinks, and red meat, as well as the irregular consumption of fruits and vegetables. To characterize the physical and social realities of a neighborhood, this study used georeferenced data of establishments selling foods, population density, homicide rates, health vulnerability Index, and total income. For data analysis, multilevel logistic regression was used. The sample consisted of 5783 adults. It was observed that younger, males, people with a lower-level education, who were inactive during leisure time, who had abusive alcohol consumption, and who were current smokers, were associated with a greater chance of having an unhealthy food intake. After adjusting for individual characteristics, it was observed that living in ABBHU, with a low mean income and an extremely high vulnerability, increases the individual's chances of having an unhealthy food intake. An unhealthy food intake is partially explained by demographic characteristics and socioeconomic conditions in the neighborhood. The present study can contribute to improving the understanding of the importance of the urban environment in food choices.