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Abstract

Introduction : The food environment has been associated with food choices and obesity however tools to measure the food environment in middle-income countries are yet unavailable. Objectives: To propose two indexes to evaluate the food environment: Healthy Meal-Restaurant Index (HM-RI) and Healthy Retail Food Store Index (HRSI). Methods: All restaurants and retail food stores located in 52 census tracts across 13 districts of São Paulo city were audited. ANOVA analyses were performed according to SES and store types. Results: In total, 472 restaurants and 313 retail food stores were found. Mean HM-RI score was 2.66 (Standard deviation - SD=0.96), 50.2% of stores scored up to 2. Higher mean scores were found in high SES areas (p<0.001) and among full service restaurants (p<0.001). Mean HRFI score was 3.15 (SD=2.36). Fruits and vegetable markets and supermarkets scored higher (p<0.001). Conclusion: The proposed tools and indexes have evidence of being able to discriminate retail food stores and restaurant types and can be used in research and practice to characterize establishments and evaluate food environment interventions.

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