Food environments and their modifications

At the beginning of the COVID-19 pandemic in Brazil and in several countries worldwide, the fear of food shortage has led part of the population to purchase great amounts of processed and ultra-processed food due to its durability, practicality and easy access in different physical and online food environments^{(Reference Khatib3,Reference Oliveira, Abranches and Lana14)} . Moreover, consumers’ perception about the risks they are exposed to and the impact of this perception on their intention and decision to purchase food should also be taken into consideration. Thus, the perception of risk associated with food supply at the beginning of COVID-19 pandemic has influenced individuals’ eating behaviour^{(Reference Khatib3)} and led them to use delivery services rather than going to the physical store.

The worsening of the COVID-19 pandemic in several Brazilian cities has led to the need of taking harder measures about social distancing, as well as to security determinations focussed on reducing human circulation and the consequent spread of the virus. These measures comprised closing public food procurement sites such as municipal markets and open fairs, as well as restricting physical access to establishments selling food for immediate consumption such as restaurants and snack bars^{(Reference Oliveira, Soares and Lima2,Reference Martinelli, Cavalli and Fabri15)} . In addition, many traders have changed the selling pattern of their establishments in order to meet community demands and to reduce the impact of the crisis^{(Reference Leone, Fleischhacker and Anderson-Steeves16)}. These measures have contributed to change the physical retail food environment^{(Reference Chang, Green and Cummins17)} through the migration of many establishments, mainly those that sell food for immediate consumption, to the virtual environment^{(Reference Oliveira, Soares and Lima2)}.

These sudden changes have significantly changed consumers’ profile since they started purchasing food through several applications and websites of the most varied food-selling establishment categories. Digital food environment has undergone significant increase in takeout/away and delivery services during the pandemic, mainly because Brazilian regulations have ordered many mass catering establishments to be closed, whereas many others had to migrate to the virtual environment^{(Reference Oliveira, Soares and Lima2)}.

Unhealthy—ultra-processed food types, such as hamburgers, pizzas, sweets in general, sugary drinks, among others, ‘are more available’ in these food purchase convenience channels^{(Reference Horta, Souza and Rocha18,Reference Botelho, Cardoso and Canella19)} . The access of different consumers to the digital environment, mainly due to issues such as physical distance between the residences and the establishments, convenient access to food and beverages^{(Reference Botelho, Cardoso and Canella19)} and overload of household activities, may contribute to the development of unhealthy eating habits in the mid and long term^{(Reference Tribst, Tramontt and Baraldi20,Reference Tokarski and Pinheiro21)} .

The digital food environment—which has been rapidly expanding in Brazil^{(Reference Botelho, Cardoso and Canella19)}—presents similar profile to all other digital categories when it comes to the influence of advertising on individuals’ food choices. This factor implies food promotion and advertising in the most different media and it may lead to unhealthy food choices^{(7,Reference Rodrigues, Souza and Horta22)} .

Consumers have been facing issues in the food environment such as worsened food affordability⁽²³⁾. Data have shown increased price of basic food items such as rice, beans and coffee powder, since the beginning of the pandemic in Brazil. Calculations made by the Inter-Union Department of Statistics and Socioeconomic Studies (DIEESE), based on data from the National Basic Food Basket Survey, have shown an increase in all 17 surveyed capitals that have recorded the highest annual increase in food prices in 2020⁽²³⁾.

In addition, consumers’ loss of purchasing power had significant impact on family farming, since farmers depend on local supply and on decentralised food marketing systems^{(Reference Schneider, Cassol and Leonardi24)} to generate income. Furthermore, a study about socioeconomic conditions in Brazil has pointed out remarkably negative impacts of the COVID-19 pandemic on family income^{(Reference Almeida, Novaes and Pessoa25)}, which can substantially lead to deleterious effects on food purchasing, mainly when it comes to the quantity and quality of purchased products. Unexpectedly some web surveys results are not showing a worsening diet quality during the pandemic period. The Nutrinet Brazil survey, which started in January 2020, back in May, 2020, showed slight increase in the consumption of healthy eating markers and stability in the consumption of unhealthy eating markers in most sociodemographic strata during the COVID-19 pandemic, except for the Northern and Northeastern macroregions in Brazil, which showed trend of increased ultra-processed food consumption^{(Reference Steele, Rauber and Costa26)}. However, results should be interpreted with caution, since it is a cohort study conducted with non-probabilistic sample and with reduced absolute number of participants in some macroregions and income strata under greater vulnerability condition^{(Reference Steele, Rauber and Costa26)}.

Most changes in food environments resulting from the pandemic may be contributing to modify food consumption among Brazilians. The Brazilian survey ConVid, conducted between April and May 2020, during the social distancing period, pointed out higher alcoholic beverage intake, decreased frequency of healthy food intake and increased frequency of unhealthy food intake due to the COVID-19 pandemic, except among the elderly population^{(Reference Malta, Morais Neto and Silva27)}.

Accordingly, a cross-sectional study was conducted with 820 adolescents in the age group 10–19 years, from different countries, including Brazil, during the pandemic, from April to May 2020. It was based on an online questionnaire distributed by social media such as WhatsApp and Twitter, and showed changes in food intake. On the one hand, there was increased vegetable intake, mainly in Brazil. On the other hand, the mean fried food and sweet intake have significantly increased during the forced confinement imposed on participants due to the COVID-19 pandemic^{(Reference Ruiz-Roso, de Carvalho Padilha and Mantilla-Escalante28)}.

With respect to the school food environment, it is known that physical distancing measures have led to school closure and had negative impact on students’ education and nutritional status. When it comes to public schools, the National School Food Program (Programa Nacional de Alimentação Escolar) accounts for ensuring adequate food for Brazilian schoolchildren during school days^{(Reference Ribeiro-Silva, Pereira and Campello29)}. However, this process was initially interrupted by the pandemic; besides, the inefficient and delayed federal guidance by the National Education System regarding National School Food Program has generated multiple and discrepant actions by state and local authorities^{(Reference Pereira, Campos and Santos30)}. Thus, on 7 April 2020, the distribution of foodstuffs purchased with federal funds to schoolchildren’s parents or legal guardians was officially authorised countrywide^{(Reference Amorim, Ribeiro and Bandoni31,32)} .

With respect to school feeding strategies adopted by state and local governments, some places used their own resources to deliver non-family farming food baskets while others performed direct cash transfer through food card/value,^{(Reference Ribeiro-Silva, Pereira and Campello29,Reference Pereira, Campos and Santos30)} and some, to a lesser extent, delivered food baskets purchased from small family farmers^{(Reference Pereira, Campos and Santos30)}.

It is noteworthy that distributing food baskets without properly planning the nutritional quality of the provided food can undermine the work of Food and Nutrition Education (Educação Alimentar e Nutricional), which has been carried out by National School Food Program over the years. The aim of Food and Nutrition Education, which is in line with the dietary guidelines for the Brazilian population⁽³³⁾, is to promote the intake of fresh and healthy foods such as fruits, vegetables and legumes, including food items belonging to local cultures and farmers. Its interruption can damage the adequate and healthy diet of schoolchildren^{(Reference Henriques, O’Dwyer and Dias34)}.

Studies conducted before the COVID-19 pandemic have shown that private schools presented a more obesogenic food environment than public schools^{(Reference Carmo, Assis and Cunha35)}. Face-to-face classes in private schools were quickly replaced by online classes; however, the same did not happen in public schools. Also, the excessive use of electronic devices and lack of contact with peers can influence sleep patterns, change eating habits, as well as trigger stress and anxiety behaviours^{(Reference Wang, Vine and Hsiao36)}. Cafeteria owners who sell food in private schools have seen their economic activity suddenly paralysed and suffered great economic impact due to the COVID-19 pandemic. Consequently, changes in ownership, in places where food is sold and in the type of food sold are expected when presential activities return. Thus, it is of paramount importance to think about strategies to reverse, rather than to worsen, the obesogenic food environment in private schools when the classroom activities return.