Avaliação do ambiente alimentar comunitário e do consumidor em uma cidade de médio porte de Minas Gerais

Abstract

This thesis aimed to evaluate the community and consumer food environment and the changes in these during the Covid-19 pandemic in Juiz de Fora, Minas Gerais. This is an ecological study. The urban regions of the municipality were categorized according to the Health Vulnerability Index. The community food environment was evaluated based on the Taxpayer Registration worksheet and the establishments were classified according to the proposal of the Interministerial Chamber for Food and Nutritional Security (CAISAN). Food deserts were classified using the CAISAN methodology and food swamps according to the Centers for Diseases Control and Prevention (CDC). The consumer's food environment was analyzed through audits in a stratified and proportional sample of establishments that sell food. The ESAO-S and ESAO-R instruments were used. Access to healthy foods was assessed using the Healthy Food Store Index (HFSI) and the Healthy Meal Restaurant Index (HMRI). To assess the changes during the period of the pandemic in the community environment, a longitudinal ecological study was carried out, in which the frequency of establishments that sell food in the months of June 2019 and October 2021 was analyzed. Availability and prices of food during the pandemic, the ESAO-S questionnaire was applied to a sample of supermarkets in the previous period (December 2019) and during the Covid-19 pandemic (September 2021). It was observed that the community food environment in the municipality is characterized by a high availability of establishments that sell ultra-processed foods. There is a low prevalence (9.4%) of in natura food purchase businesses. Regarding the regions considered food deserts and food swamps, prevalences of 25% and 68% were observed, respectively. It was identified that less than half of the establishments selling food for consumption at home offered fruits and vegetables. Additionally, there is a high availability of ultra-processed foods, such as soft drinks, industrialized juices, cookies and corn snacks. Regarding the changes that occurred during the Covid-19 pandemic, there was a reduction in in natura food stores and an increase in ultra-processed and mixed food acquisition establishments, with these changes being different according to the IVS in the region. The worrying percentage of regions classified as food swamps in the post-pandemic period stands out: 86.4%. When evaluating the consumer's food environment, a significant increase in the price of fresh foods such as oranges, bananas, apples and onions and a greater variety of ultra-processed foods such as soft drinks, powdered refreshments and corn chips during the pandemic were found. The findings of this thesis make it possible to understand the characteristics of the community and consumer food environment and the impacts of the Covid-19 pandemic, helping to formulate public policies in order to 12 provide access to healthy foods and, consequently, influence food consumption and prevent negative health outcomes such as obesity and chronic diseases.