Mapping the Healthiness of Campus Food Environments in Nigeria: In-Store Retail and Outdoor Advertising Assessments at Selected Universities-The NigeFE Study.

The rising burden of obesity and non-communicable diseases among young people has prompted global recommendations for healthier food environments, but evidence is limited across African universities. This study aims to assess the healthiness and spatial distribution of university food environments using in-store retail audits and outdoor food advertising assessments. Outdoor food advertisements were audited in two universities (excluding the University of Ibadan), while retail stores were assessed across three participating institutions within a 300-500 m radius of each campus. Data were collected using the INFORMAS protocol and the NEMS-S-MED in-store audit tool, respectively, alongside spatial analyses. A total of 76 food advertisements and 145 food retail stores were identified. Less than one-tenth (7.5%) of advertised products were healthy. Healthier foods in retail stores were predominantly characterised by moderately low (37.2%) and medium (31.7%) availability, while affordability was low (73.1%), resulting in over half being classified as having a low (51.7%) degree of healthiness. These differed significantly across institutions (p < 0.05), with the University of Nigeria, Nsukka (UNN) having a more diverse, spatially dispersed and healthier food environment. There is a need to restrict unhealthy food advertising and encourage vendors' procurement and the sale of healthier foods.