To assess the availability and marketing of ultra-processed foods (UPFs) in modern retail food outlets (supermarkets and minimarts) in Kenya and associated factors.

This cross-sectional study was conducted in Kenya from August 2021 to October 2021. Variables included; the geographic location and the socioeconomic status levels (SES), the food items displayed for sale and advertised in the stores, and locations in the stores such as the entrance.

Three counties in Kenya (Nairobi - urban, Mombasa - coastal tourist, and Baringo- rural). Each county was stratified into high and low SES using national poverty indices.

Food outlets that offered a self-service, had at least one check-out, and had a minimum of two stocked aisles were assessed.

Of 115 outlets assessed, UPFs occupied 33% of the cumulative shelf space. UPFs were the most advertised foods (60%) and constituted 40% of foods available for sale. The most commonly used promotional characters were cartoon characters (18%). UPFs were significantly more available for sale in Mombasa (urban) compared to Baringo (rural) (Adjusted prevalence rate ratios (APRR): 1.13, 95% confidence interval (CI): 1.00-1.26, p=0.005). UPFs advertisements were significantly higher in Mombasa ((APRR): 2.18: 1.26-3.79, p= 0.005) compared to Baringo and Nairobi counties. There was a significantly higher rate of advertisement of UPFs in larger outlets ((APRR): 1.68: 1.06-2.67 p=0.001) compared to smaller outlets.

The high marketing and availability of UPFs in modern retail outlets in Kenya calls for policies regulating unhealthy food advertisements in different settings in the country.

Food environments are a major determinant of children’s nutritional status. Scarce evidence on food environments exists in low- and middle-income countries (LMIC). This study aims to fill this gap by documenting the obesogenicity of food environments around schools in Greater Tunis, Tunisia – an LMIC of the Middle East and North Africa region with an ongoing nutrition transition and increasing rates of childhood obesity.

In this cross-sectional study, we assessed built food environments around fifty primary schools. Ground-truthing was performed to collect geographic coordinates and pictures of food retailers and food advertisement sets within an 800-m road network buffer of each school. Retailers and advertisement sets were categorised as healthy or unhealthy according to a NOVA-based classification. Associations between school characteristics and retailers or advertisement sets were explored using multinomial regression models.

Greater Tunis, Tunisia.

Random sample of fifty (thirty-five public and fifteen private) primary schools.

Overall, 3621 food retailers and 2098 advertisement sets were mapped. About two-thirds of retailers and advertisement sets were labelled as unhealthy. Most retailers were traditional corner stores (22 %) and only 6 % were fruit and vegetable markets. The prevailing food group promoted was carbonated and sugar-sweetened beverages (22 %). The proportion of unhealthy retailers was significantly higher in the richest v. poorest areas.

School neighbourhood food environments included predominantly unhealthy retailers and advertisements. Mapping of LMIC food environments is crucial to document the impact of the nutrition transition on children’s nutritional status. This will inform policies and interventions to curb the emergent childhood obesity epidemic.