title: Association of neighbourhood food availability with the consumption of processed and ultra-processed food products by children in a city of Brazil: a multilevel analysis.
abstract: OBJECTIVE
  To investigate the association between neighbourhood food availability and the consumption of ready-to-consume products (RCP), either processed or ultra-processed, and unprocessed/minimally processed foods (UF-MPF) by children.
  
  
  METHODS
  Cross-sectional. 24 h Dietary recalls were collected from children from January 2010 to June 2011. Neighbourhood food availability data were collected from 672 food stores located within 500 m of participants' homes, using an adapted and validated instrument. Neighbourhood-level socio-economic status (SES) was obtained by calculating the mean years of household head's education level in each census tract covered by 500 m buffers. Foods that were consumed by children and/or available in the food stores were classified based on their degree of industrial processing. Multilevel random-effect models examined the association between neighbourhood food availability and children's diets.
  
  
  METHODS
  Santos, Brazil.
  
  
  METHODS
  Children (n 513) under 10 years old (292 aged <6 years, 221 aged ≥6 years).
  
  
  RESULTS
  The availability of RCP in food stores was associated with increased RCP consumption (P<0·001) and decreased UF-MPF consumption (P<0·001). The consumption of UF-MPF was positively associated with neighbourhood-level SES (P<0·01), but not with the availability of UF-MPF in the neighbourhood.
  
  
  CONCLUSIONS
  Results suggest that food policies and interventions that aim to reduce RCP consumption in Santos and similar settings should focus on reducing the availability in food stores. The results also suggest that interventions should not only increase the availability of UF-MPF in lower-SES neighbourhoods, but should strive to make UF-MPF accessible within these environments.
authors.affiliation: 1Department of Human Movement Science,Nutritional Epidemiology Laboratory,Federal University of Sao Paulo,95 Ana Costa Avenue,Santos,Sao Paulo 11060001,Brazil.
authors.forename: Fernanda Helena Marrocos
authors.initials: FHM
authors.lastname: Leite
authors.affiliation: 1Department of Human Movement Science,Nutritional Epidemiology Laboratory,Federal University of Sao Paulo,95 Ana Costa Avenue,Santos,Sao Paulo 11060001,Brazil.
authors.forename: Elena
authors.initials: E
authors.lastname: de Carvalho Cremm
authors.affiliation: 1Department of Human Movement Science,Nutritional Epidemiology Laboratory,Federal University of Sao Paulo,95 Ana Costa Avenue,Santos,Sao Paulo 11060001,Brazil.
authors.forename: Débora Silva Costa
authors.initials: DSC
authors.lastname: de Abreu
authors.affiliation: 1Department of Human Movement Science,Nutritional Epidemiology Laboratory,Federal University of Sao Paulo,95 Ana Costa Avenue,Santos,Sao Paulo 11060001,Brazil.
authors.forename: Maria Aparecida de
authors.initials: MA
authors.lastname: Oliveira
authors.affiliation: 2Centers for Disease Control and Prevention,National Center for Chronic Disease Prevention and Health Promotion,Division of Nutrition,Physical Activity,and Obesity,Atlanta,GA,USA.
authors.forename: Nadine
authors.initials: N
authors.lastname: Budd
authors.affiliation: 1Department of Human Movement Science,Nutritional Epidemiology Laboratory,Federal University of Sao Paulo,95 Ana Costa Avenue,Santos,Sao Paulo 11060001,Brazil.
authors.forename: Paula Andrea
authors.initials: PA
authors.lastname: Martins
mesh_terms: D015992:Body Mass Index; D001938:Brazil; D002648:Child; D003430:Cross-Sectional Studies; D004032:Diet; D057140:Fast Foods; D005260:Female; D005511:Food Handling; D005523:Food Supply; D006801:Humans; D008297:Male; D011939:Mental Recall; D055361:Multilevel Analysis; D009752:Nutritional Status; D012111:Residence Characteristics; D012959:Socioeconomic Factors
keywords: Children; Food consumption; Food environment; Neighbourhood; Ultra-processed food products