Anaemia, overweight and abdominal obesity in mothers and children are associated with the food environment in socially vulnerable areas of a northeastern Brazilian capital

This study aimed to assess the association between community and consumer food environment (FE) measures and anaemia, overweight and abdominal obesity in mother-child dyads living in situations of social vulnerability. A cross-sectional study was carried out in 40 favelas in a capital city in the northeast of Brazil. The sample consisted of 1882 women and 665 children aged under 5 years. The community FE was assessed using a scale of perception of the availability of healthy food in the neighbourhood. Consumer FE was assessed by auditing 624 retail food stores using the AUDITNOVA instrument. This investigated various aspects of the food environment and evaluated the availability of 18 ultra-processed foods (UPF) most consumed by the Brazilian population available in these stores. The presence of overweight was assessed by measuring the weight and height of the mother and the child, and abdominal obesity was assessed by measuring the mother's waist circumference. The presence of anaemia in the mother and the child was assessed by measuring haemoglobin. Adjusted multilevel regression models were used to verify associations between the FE and malnutrition in mother-child dyads. Low perception of community FE was associated with higher risk of women being overweight (OR: 1.35; 95% CI: 1.05-1.73) and abdominally obese (OR: 1.38; 95% CI: 1.04-1.84); low health scores in food shops were associated with higher risk of abdominal obesity (OR: 1.35; 95% CI: 1.01-1.79) and anaemia (OR: 1.16; 95% CI: 1.02-1.98) in women and overweight in children (OR: 1.69; 95% CI: 1.05-2.73); and the high availability of UPF in retail shops was associated with increased odds of overweight (OR: 2.64; 95% CI: 1.61-4.33) and anaemia (OR: 2.11; 95% CI: 1.38-3.02) in children by 164% and 111%, respectively. It was observed that less healthy food environments are associated with greater chances of anaemia, overweight and abdominal obesity in mothers and children under 5 years in situations of social vulnerability in Brazil.