Association between the food environment of Brazilian public and private schools and the consumption of ultra-processed foods: Analysis of the National Student Health Survey (PeNSE) 2019

The school food environment can influence the eating habits and dietary practices of adolescents. This study assessed associations between the school food environment and the consumption of ultra-processed foods by Brazilian adolescents in public and private schools using data from Brazil's 2019 National Student Health Survey. Food consumption was assessed by self-reported consumption of 13 ultra-processed foods on the previous day whereas the school food environment was assessed using an indicator of food and beverage availability in the school canteens and surroundings. Multilevel logistic regression models adjusted for sociodemographic variables and including a random intercept at the school level were used to assess the association between high consumption of ultra-processed foods and the school environment score. Students from both public and private schools who were enrolled in schools in the highest quartile for the food and beverage availability score showed lower odds of high consumption of ultra-processed foods. A healthier school food environment, with a higher supply of fresh and a lower supply of ultra-processed foods, is associated with better dietary habits among Brazilian adolescents.