Caracterização do ambiente alimentar das escolas brasileiras públicas e privadas: dados da pesquisa nacional de saúde do escolar (PeNSE) 2019

Abstract

Dietary patterns, socioeconomic, and cultural factors constitute the food environment in each social sphere. The school food environment is essential for shaping the eating behaviors of school-aged children and adolescents. Therefore, understanding the food environment in schools is crucial. This is a cross-sectional study that used data from the 2019 National Survey of School Health (PeNSE). We executed weighted prevalence and prevalence ratio of food environment characteristics by school administrative status using brute and adjusted Poisson regression (PR), both with corresponding confidence intervals (95% CI). A total of 4,242 Brazilian schools were analyzed, with 49.7% public and 50.3% private. Among them, 88.4% adhere to some type of food regulation policy, with higher adherence among public schools (96.1%). Private schools showed a prevalence of food or beverage sales in canteens four times higher than public schools (PR = 3.71; 95% CI: 3.42–4.01), while alternative points of sale were more prevalent in public schools (PR = 0.67; 95% CI: 0.62–0.73). Sales of fresh fruit or fruit salad (PR = 3.32; 95% CI: 2.23–4.93), sandwiches (PR = 1.85; 95% CI: 1.40–2.46), and milk-based drinks and chocolate milk (PR = 1.78; 95% CI: 1.46–2.16) were higher in private school canteens. Alternative points of sale in private schools had a higher prevalence of natural fruit juice sales (PR = 1.21; 95% CI: 1.05–1.40), while sales of cookies, crackers, and packaged snacks were lower (PR = 0.73; 95% CI: 0.59–0.89) and (PR = 0.79; 95% CI: 0.72–0.86), respectively. Private schools follow food regulations less strictly, leading to higher sales of ultra-processed products but also greater availability of healthy options, including nearby locations, compared to public schools. These differences suggest that public and private school food environments have distinct characteristics that may contribute to unhealthy eating behaviors, such as the wide availability of ultra-processed foods.