# Perception of the Food Environment and Availability of Unprocessed and Ultra-Processed Foods in the Households of Brazilian Schoolchildren During the COVID-19 Pandemic

## TL;DR

This study found that during the pandemic, most Brazilian households had high availability of ultra-processed foods, and perceptions of the local food environment influenced this.

## Contribution

The study links perceived food environment factors to household food availability during the pandemic in Brazil.

## Key findings

- 92.6% of households had high availability of ultra-processed foods.
- Positive perception of ultra-processed food variety was more common in households with high availability.
- Positive perception of fresh food variety was associated with lower odds of high ultra-processed food availability.

## Abstract

This study assessed perceptions of the food environment and its association with the availability of unprocessed, minimally processed, and ultra-processed foods in the households of Brazilian schoolchildren during the COVID-19 pandemic. A cross-sectional telephone survey (n = 475) was conducted between March, April and May 2021 with a representative sample of households with public school students from two Brazilian municipalities. Household food availability was assessed using a frequency questionnaire referring to the 30 days prior to the survey. Perception of the food environment was assessed using questions that measured perceived availability, price, and quality of fruits and vegetables (FV) and ultra-processed foods (UPF) sold in the neighbourhood. To analyse the association between perceived food environment and food availability, univariate and multivariate logistic regression analyses were performed, with 95% CI. The results indicate that high availability of unprocessed or minimally processed foods was found in 7.4% of households and high availability of UPF in 92.6%. Positive perception of UPF variety in the neighbourhood was more prevalent in households with greater availability of these foods (p < 0.05). After adjustment for sociodemographic characteristics, a positive perception of FV variety was associated with lower odds of high household UPF availability (OR = 0.54; 95%CI: 0.30–0.97). Perception of the food environment is an important factor associated with household UPF availability. Policy interventions should consider promoting healthier food environments by expanding the distribution of fresh foods alongside measures that ensure economic access to these foods.