Lead Article Retail food environment around schools and overweight: a systematic review Carla Marien da Costa Peres, Danielle Soares Gardone, Bruna Vieira de Lima Costa, Camila Ku ¨ mmel Duarte, Milene Cristine Pessoa, and Larissa Loures Mendes Context: The presence of retail food establishments around schools can be a po- tentiating 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 establish- ments around schools and the occurrence of overweight and obesity in schoolchil- dren 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 accord- ing 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 over- weight 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 influ- ence 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. INTRODUCTION Obesity in children and adolescents is the result of a complex interaction between individual and environ- mental variables. Recent efforts have been directed toward understanding the role of the environmental context in the changes in dietary and physical activity patterns in this specific group, 1–4 especially because the prevention and reduction of childhood obesity are more effective when not only the individual is taken Affiliation: C.M. da Costa Peres, D.S. Gardone, L.L. Mendes, B.V.d.L. Costa, and M.C. Pessoa are with the Post-Graduate Program in Nutrition and Health, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. L.L. Mendes, B.V.d.L. Costa, C.K. Duarte, and M.C. Pessoa are with the Department of Nutrition, Federal University of Minas Gerais, Belo Horizonte, Minas Gerais, Brazil. Correspondence: L.L. Mendes, Department of Nutrition, Federal University of Minas Gerais, Ave. Alfredo Balena, 190, Office 314, Belo Horizonte, MG, Brazil, CEP 30130-100. E-mail: larissalouresmendes@gmail.com. Key words: childhood obesity, food environment, schools. V C The Author(s) 2020. Published by Oxford University Press on behalf of the International Life Sciences Institute. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com. doi: 10.1093/nutrit/nuz110 Nutrition Reviews V R Vol. 78(10):841–856 841 Downloaded from https://academic.oup.com/nutritionreviews/article/78/10/841/5714192 by guest on 01 March 2023