Association Between the Food Environment Around Schools and Food Consumption of Adolescents in Large and Small Municipalities in Southern Brazil.

This cross-sectional study aimed to evaluate the association between the consumption of healthy and unhealthy food markers among adolescents enrolled in the ninth grade of elementary school in municipal public schools and the food environment around the schools in two municipalities of different sizes, located in Southern Brazil. The data were collected between 2022 and 2023, with 449 adolescent participants. Of these, 347 were students from the municipality of Florianópolis, and 102 were students from the municipality of Governador Celso Ramos, all aged between 13 and 17 years. The establishments located around the schools were evaluated using AUDITNOVA, an instrument that investigates the environmental dimension and food dimension. The consumption of healthy eating markers (beans, vegetables, and fresh fruits) and unhealthy eating markers (ultra-processed foods, soft drinks, sweets, and fried snacks) among students was assessed using a food frequency questionnaire. Statistically significant associations were observed between the food environment around the school and the consumption of unhealthy food markers (OR = 0.63; 95% CI = 0.41-0.98 p = 0.041) but only in the large municipality. No significant associations were found in the students' food consumption in the small municipality. A significant association between the school food environment and adolescents' consumption of unhealthy foods was observed in Florianópolis. Healthy food consumption was low among students in the small municipality, Governador Celso Ramos.