Food environment and consumption of ultra-processed foods influencing food addiction in socially vulnerable women in Brazil.

Objective: This study aimed to evaluate the association between food addiction (FA), food environment, and consumption of ultra-processed foods (UPF) in socially vulnerable women.

Design: A population-based cross-sectional study was conducted in Favelas and Urban Communities of Maceió-Brazil. The availability of ultra-processed foods in the food environment was evaluated through the audit of retailers with the support of the AUDITNOVA instrument. The women taking part in the study were interviewed, and a 24-hour food recall was used to assess the proportion of UPF in their diet. The modified Yale Food Addiction Scale 2.0 was also used to determine FA. Association analysis was performed using binary logistic regression and generalized estimation equations.

Participants: 1,702 adult women of reproductive age (20-44 years) residents in Favelas and Urban Communities.

Results: It was found that 14.6% of the women had FA. The adjusted multivariate association analysis showed that the high availability of ultra-processed foods in food retail increased the chance of women having FA by up to 47% (p=0.02 OR: 1.53; 95% CI: [1.07; 2.18]). It was also possible to observe that the greater calorific contribution of UPF in the diet increased the chance of women presenting FA by up to 61% (p< 0.01 OR: 1.39; 95% CI: [1.48; 1.97]).

Conclusions: The environment and what is available in it is associated with additive behavior independent of individual factors, and UPF consumption increases the chance of FA. This demonstrates the need for changes in the food environment in Brazilian favelas, contributing to improving women's health.