Context The presence of retail food establishments around schools can be a potentiating or protective factor for overweight in students, depending on access to these places as well as types of foods available therein. The hypothesis for this study was that a greater density and proximity of retail food establishments around schools influence the weight of students. Objective To systematically review the available observational literature on the association between retail food establishments around schools and the occurrence of overweight and obesity in schoolchildren and adolescents. Data Sources Observational studies were searched in the MEDLINE, EMBASE, and SCOPUS databases published until May 2019. Data Extraction Two independent reviewers extracted relevant data. Data Analysis Data on the 31 included studies were summarized with narrative synthesis according to meta-analyses of observational studies in epidemiology, exploring the type of food establishments around schools and analyzing qualitatively the impact of proximity or density on overweight and obesity rates. Conclusion Of the 31 articles, a direct association between proximity or density of establishments (mainly fast food restaurants, convenience stores, grocery stores) around schools and overweight and obesity in children and adolescents were found in 14 studies. However, authors of 13 papers found no association and inverse association was presented in 4 papers. The studies presented different methods of classification, location, and analysis of retail food establishments, making it difficult to conclude the real influence that the presence of these establishments near schools have on the nutritional status of children and adolescents. Therefore, future studies should consider the use of longitudinal designs and standardized analysis of the food environment around schools to better understand this food environment and its influence on health-related behaviors.

Objective: To assess the association of obesogenic environmental characteristics around schools with body adiposity and adipokine concentrations in Brazilian children. Design: Cross-sectional study. Body adiposity was assessed using the dual-energy X-ray absorptiometry (DXA). Concentrations of leptin, adiponectin, retinol-binding protein 4 (RBP4), and chemerin were measured. Predominantly ultra-processed food (UPF) stores, public physical activity (PA) facilities, green spaces, walkability, traffic accidents, and crime were evaluated. The neighborhood unit was the 400 m (0.25 miles) road network buffer around schools. The association of environmental characteristics with body adiposity and adipokine concentrations was assessed by linear regression models using Generalize Estimating Equations (GEE). Setting: Urban schools (n=24), Viçosa, Minas Gerais, Brazil. Participants: Children aged 8 and 9 years (n=378). Results: A higher density of predominantly UPF stores and a lower percentage of green space were associated with higher total (β: 0.12; 95%CI: 0.06, 0.18; and β: -0.10; 95%CI: -0.16, -0.04, respectively) and android body fat (β: 0.28; 95%CI: 0.13, 0.43 and β: -0.18; 95%CI: -0.32, -0.04, respectively). In addition, the densities of PA facilities and crime were inversely associated with leptin concentrations. Traffic accidents density and percentage of green spaces around schools had, respectively, a positive and an inverse association with concentrations of adiponectin and RBP4. Conclusions: Obesogenic environmental characteristics around schools were associated with total and android body fat, as well as with pro-inflammatory adipokine concentrations in Brazilian children from a medium-sized city.

Context The community food environment covers the type, quantity, density, location, and access to retail food outlets, and its influence on eating behavior, obesity, and metabolic syndrome has been investigated. Objective To evaluate the evidence on longitudinal associations between objectively measured retail food outlets and metabolic syndrome components in children, adolescents, and adults. Data extraction This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Study quality and risk of bias were assessed with the Newcastle-Ottawa Scale. Data sources The Scopus, Embase, Web of Science, Scielo, PubMed, MEDLINE, and Lilacs databases were searched without any restriction on publication dates. Data analysis Of the 18 longitudinal studies included, significant associations were reported in 9 between retail food outlets and metabolic syndrome components in adults (6 positive associations, 2 negative, and 1 both positive and negative), and in 3 studies of children and adolescents (2 negative associations and 1 both positive and negative). Six studies with adults found no association. Conclusion Limited evidence was found for longitudinal associations between retail food outlets and metabolic syndrome components. In future studies, researchers should consider the use of standardized retail food outlet measurements and accurate analysis to better understand the influence of the community food environment on metabolic syndrome. Systematic Review Registration PROSPERO registration no: CRD42020177137.

O objetivo foi avaliar o ambiente alimentar comunitário e a existência de pântanos alimentares no entorno das escolas de uma metrópole brasileira. Trata-se de um estudo ecológico realizado em escolas públicas e privadas de Belo Horizonte, Minas Gerais, Brasil, e teve como unidade de análise o buffer de 250m. Foram incluídas no estudo todas as escolas de Educação Infantil, de Ensinos Fundamental e Médio. Em relação às escolas, foram avaliadas a dependência administrativa e o tipo de ensino ofertado, bem como a renda per capita dos setores censitários das escolas. Contabilizou-se também as informações sobre os estabelecimentos de venda de alimentos para o consumo imediato que estavam dentro do buffer no entorno das escolas. Em relação ao ambiente alimentar foram avaliados apenas os estabelecimentos que comercializam alimentos para o consumo imediato no entorno escolar. A análise dos buffers revelou que 97,4% das escolas tinham ao menos um desses estabelecimentos no seu entorno. Os estabelecimentos mais disponíveis no entorno da escola foram lanchonetes, restaurantes e bares. As escolas localizadas em setores censitários de maior renda apresentavam maior média de todos os estabelecimentos no seu entorno, exceto das mercearias e supermercados. Ademais, 54,6% das escolas estavam em vizinhanças que são classificados como pântanos alimentares. Os resultados revelam que entre as categorias avaliadas ocorre um predomínio dos estabelecimentos que comercializam, predominantemente, alimentos ultraprocessados, como os bares e lanchonetes no entorno das escolas de Belo Horizonte, o que expõe as crianças e os adolescentes a um ambiente alimentar não saudável.

Cirurgia cardíaca, Complicações pós-operatórias, Índice de massa corporal, Fatores de risco