Objective:To evaluate the association of a combined measure of availability and use of
facilities from the food environment and overweight (including obesity)
among schoolchildren, while taking into account the physical activity and
social-assistance environments.Methods:Cross-sectional study with a probabilistic sample of schoolchildren aged 7 to
14 years living in a southern Brazilian city (n = 2026). Multilevel analyses
were performed with overweight as outcome and the food environment as main
exposure. Models were adjusted for the physical activity and
social-assistance environments, as well as individual and other residential
neighborhood characteristics.Results:Greater availability of restaurants around the home was associated with
higher odds of overweight (odds ratio [OR] = 1.40; 95% CI = 1.06-1.85).
Stronger associations were found for schoolchildren reporting to use
restaurants (OR = 1.48; 95% CI = 1.15-1.90). This association remained
significant after adjusting for the presence of other food retailers.
Schoolchildren who had social-assistance facilities around their homes, but
reported not to use them, showed consistently higher odds of being
overweight (OR = 1.34; 95% CI = 1.01-1.78) as compared to schoolchildren who
had these facilities near home and used them. The physical activity
environment was not associated with the outcome.Conclusions:Availability and use of the food and social-assistance environments were
significantly associated with overweight (including obesity) among the
schoolchildren. Future research should consider the use of environmental
facilities in combination to their geographical availability. Our results
highlight the need for policies that limit the access to obesogenic food
outlets by children and adolescents.