Exploring the relationship between food environment and preferences among school children in a low socio-economic community in Sri Lanka: A GIS based assessment

Food environment in school neighborhood plays a crucial role in manipulating food choices of school children. This study investigated the relationship between food environment in neighborhood and dietary practices of government school students in a low socio-economic setting, Sri Lanka. This cross-sectional study surveyed the neighborhood food environment of selected schools (n=30) in Monaragala District, Sri Lanka, using Geographical Information System (GIS) data, and collected dietary information from a representative sample of school children (n=603). Chi-square and spearman correlation tests were performed using SPSS version 23.0 to estimate the associations between food environment and BMI of students, while ArcGIS 10.4.1 was used to analyze GIS data of the study. Majority of students (35.5%) were 15 years old and approximately 51% were females. Mean BMI of study participants was 18.14 (± 3.28). More than 90% of outlets within close proximity sold unhealthy foods. Consumption of confectionaries was 72.3% of students whereas healthy foods choices was ranged from 5% to 12%. A positive correlation between consuming unhealthy food and distance to the outlets from the school was observed (p<0.05). Risk of consuming low nutrition food found to be doubled (OR = 2.47, 95% CI: 1.52-3.89) among students studied in schools where larger proportion of energy dense food sold in closer proximity. In conclusion, density and the proximity of the outlets that sold food in low nutrients in school neighborhood environment were positively associated with choosing unhealthy food items by students.