Objective: Food delivery apps represent an important and emerging dimension of the digital food environment. This study aimed to examine food availability and the use of marketing strategies by two food delivery apps in a Brazilian metropolis.Design: An exploratory study was conducted in the city of Belo Horizonte, Minas Gerais. Food groups were identified and the use of price discounts and photos by the apps was observed.Setting: Eighteen neighbourhoods and the ten best rated restaurants in each app.Participants: Three hundred sixty-two commercial food establishments.Results: The proportion of ultra-processed beverages on offer in the apps (78·45 %) was much higher in comparison with water (48·89 %), natural juices or smoothies (27·07 %). Ultra-processed ready-to-eat meals represented almost 70 % of the food offered in the establishments’ menus, while traditional meals and vegetables represented just over 30 % of the offering. Ice cream, candies and salty packaged snacks were nine times more frequently presented than fruits. The use of photos and price discounts prevailed predominantly among ultra-processed beverages, sandwiches and ice cream, candies and salty packaged snacks. These marketing strategies were least used for promoting fruits and vegetables.Conclusions: Restaurants registered on food delivery apps offered a significant amount of ultra-processed foods with price discounts and photos in comparison with unprocessed and minimally processed foods.

Background: Food deserts are neighborhoods with little or no access to healthy food, whereas food swamps are neighborhoods where unhealthy food options prevail over healthy ones. The main aims of the current study are to feature and compare the neighborhoods of food deserts and food swamps based on social inequality. Methods: Ecological study carried out in Belo Horizonte City, Minas Gerais State, Brazil. Information about commercial food establishments derived from two different databases. It was measured by secondary governmental databases, which were virtually conferred in the present study. Census tracts were considered as analysis units and classified as food deserts and food swamps, based on the Brazilian methodology. Take into consideration the density of establishments classified as selling fresh or minimally-processed food, mixed establishments, and establishments selling ultra-processed food. The Brazilian methodology evaluates food deserts by the density of healthy establishments (establishments classified as mostly selling fresh or minimally-processed food and mixed establishments) per 10 thousand inhabitants. And the metric to evaluate food swamps considers the density of unhealthy establishments (establishments mostly selling ultra-processed food) per 10 thousand inhabitants. Information about social inequalities comprised aspects such as income, population count, number of households, number of literate individuals, race, water and energy supply, and garbage collection. The Health Vulnerability Index (HVI) was used as a synthetic social vulnerability indicator. Results: Neighborhoods of food deserts presented worse essential service availability, lower income per capita, and smaller mean number of literate individuals. Census tracts classified as food swamps presented better socio-demographic conditions than those areas food deserts. Neighborhoods simultaneously classified as food deserts and food swamps presented lower income per capita and were more often observed in census sectors presenting medium and high HVI. Conclusion: The food environment in Belo Horizonte was featured by the strong presence of food deserts and food swamps. However, the potential influence of these areas on food intake has changed depending on social inequalities.

Online food delivery (OFD) platforms guarantee access to food during the coronavirus disease 2019 (COVID-19) pandemic when commercial food establishments are closed and access to food retail is controlled. The present study aimed to describe the advertisements published in an OFD platform in Brazilian capitals, during the 13th and 14th weeks of the pandemic. Data collection occurred on 1 d of the week and 1 d of the weekend and during lunch and dinner time. A random sample of 25 % of the advertisements (n1754) published in this period was classified in accordance with the presence of food groups and to the use of marketing strategies. Sandwiches, ultra-processed beverages, traditional meals or pasta were the most common food groups shown in the advertisements. Free delivery prevailed in advertisements of ice cream, candies or salty packages snacks and pizza (P< 0·01). Combos were more frequently shown in the advertising of natural juices or smoothies, ultra-processed beverages, sandwiches and pizzas (P< 0·01). Messages about healthiness were more seen among natural juices or smoothies, vegetables and traditional meals and pasta advertisements (P< 0·01) and less seen in sandwiches (P= 0·02) and pizza advertisements (P< 0·01). Economy messages were rare in advertisements of traditional meals or pasta (P< 0·01) and more common in ultra-processed beverages (P= 0·03) and ice cream, candies or salty packages snacks (P< 0·01) advertisements. The OFD platform promoted unhealthy eating during the COVID-19 pandemic in Brazil due to the expressive presence of unhealthy foods advertising.

To analyze the occurrence of anemia and iron deficiency in children aged 1 to 5 years and the association of these events and retinol deficiency. This was an observational analytic cross-sectional study conducted in Vitoria, ES, Brazil, between April and August of 2008, with healthy children aged 1 to 5 years (n=692) that lived in areas covered by primary healthcare services. Sociodemographic and economic conditions, dietary intake (energy, protein, iron, and vitamin A ingestion), anthropometric data (body mass index-for-age and height-for-age), and biochemical parameters (ferritin, hemoglobin, and retinol serum) were collected. The prevalence of anemia, iron deficiency, and retinol deficiency was 15.7%, 28.1%, and 24.7%, respectively. Univariate analysis showed a higher prevalence of anemia (PR: 4.62, 95% CI: 3.36, 6.34, p<0.001) and iron deficiency (PR: 4.51, 95% CI: 3.30, 6.17, p<0.001) among children with retinol deficiency. The same results were obtained after adjusting for socioeconomic and demographic conditions, dietary intake, and anthropometric variables. There was a positive association between ferritin vs. retinol serum (r=0.597; p<0.001) and hemoglobin vs. retinol serum (r=0.770; p<0.001). Anemia and iron deficiency were associated with low levels of serum retinol in children aged 1 to 5 years, and a positive correlation was verified between serum retinol and serum ferritin and hemoglobin levels. These results indicate the importance of initiatives encouraging the development of new treatments and further research regarding retinol deficiency.

Objective: To analyse food advertised on an online food delivery (OFD) platform during 16 weeks of the COVID-19 pandemic in Brazil.Design: Longitudinal study. We randomly selected foods advertised on the OFD app’s home page, classifying the food items into: water; natural juices and smoothies; vegetables; fruits; traditional meals and pasta; ultra-processed beverages; ice cream, candies, and salty packaged snacks; sandwiches; savoury snacks; and pizza. We also registered the marketing strategies used to promote the food items, such as photos, discounts, ‘combo deals’, and messages on healthiness, value for the money, tastiness, and pleasure.Setting: Belo Horizonte, Minas Gerais, Brazil.Participants: 1593 food items.Results: In general, the OFD platform most commonly promoted traditional meals and pasta, ultra-processed beverages, and sandwiches – these food groups were offered 20–25 % of the time during the 16 weeks. There were no promotions for water during the whole period, and the least common promotions were those for natural juices and smoothies, vegetables, and fruits (< 5 %). The most common food promotion strategies were photos (> 80 %) and discounts (> 95 %), while approximately 30 % of the offers featured combo deals. Messages on tastiness, pleasure and value for the money varied from 15 % to 40 %.Conclusion: Although the OFD platform offered traditional meals and pasta, most of the foods and beverages advertised were unhealthy and promoted with persuasive strategies. This finding highlights a growing public health concern: an increase in unhealthy eating patterns during the pandemic.