Individual and environmental factors affect the consumption of ultra-processed foods among Brazilian adolescents: results from the National School Health Survey

Abstract

Abstract This population-based cross-sectional study investigated the complex interplay of factors influencing high ultra-processed food (UPF) consumption among Brazilian adolescents using a hierarchical socioecological model. Data from 100,028 adolescents (13-17 years) enrolled in public and private schools nationwide were collected via self-administered questionnaires from the 2019 National School Health Survey. High UPF consumption was defined as ≥7 subgroups consumed on the previous day based on the NOVA classification. Poisson regression adjusted for complex sampling and hierarchical structure identified Prevalence Ratios (PR) for associated factors. High UPF consumption was significantly associated with younger age (PR=1.22; 95%CI 1.11-1.34), regular breakfast consumption (PR=1.32; 95%CI 1.23-1.42), regular screen time during meals (PR=1.36; 95%CI 1.27-1.45), frequent UPF purchases at and around school (PR for canteen: 1.57; 95%CI 1.43-1.72; street vendors: 1.71; 95%CI 1.55-1.89), higher maternal education (PR 1.23, 95% CI 1.12-1.36), and lower parental supervision (PR 1.34, 95% CI 1.11-1.62). Living in the South (PR 1.50, 95% CI 1.34-1.69), Southeast (PR 1.30, 95% CI 1.17-1.44) and Midwest regions (PR 1.21, 95% CI 1.09-1.34) also correlated with higher consumption. Conversely, high body satisfaction and attending private school showed an inverse association. These findings underscore the intricate, multilevel influences on UPF consumption among Brazilian adolescents. Integrated interventions, spanning schools, family environments, and public policies, are crucial for promoting healthier eating habits and preventing obesity in this vulnerable population.

Keywords

Affiliated Institutions

• Instituto Federal do Rio Grande do Norte BR
• Universidade Federal da Paraíba BR

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