Food Environment, Diet Quality and Disparities in Obesity

描述（由申请人提供）：西雅图肥胖研究（S.O.S）旨在解释为什么肥胖率在一些少数种族/民族、教育和收入较低的人口亚群以及高贫困地区更为普遍。该研究将招募一个纵向队列，包括400名年龄在21- 65岁之间的男性和女性成年人，居住在西雅图-金县，并使用基于地址的抽样方案按收入和种族/民族分层。将使用自我报告和客观测量相结合的方法收集有关觅食行为的数据。在第一次面对面访谈时，参与者将完成一个行为调查模块，内容包括食品购物和饮食习惯、估计的食品支出、营养素养、对饮食和健康的态度、人口统计学和健康状况。与健康相关的问题将涉及肥胖、糖尿病、压力和心血管疾病。将测量身高、体重和腰围。具有数据记录功能的GPS接收器将用于跟踪参与者的运动，并记录1周内所有食物相关事件的时间和位置。将在4周内收集印有时间和日期的食品商店和餐馆收据。将使用便携式UPC扫描仪对带入家中的食品进行4周扫描。在第3周和第4周通过电话进行3次24小时食品召回，并在数据收集的第4周进行食物频率问卷调查。为了能够确定环境和饮食变量与健康结局之间的因果关系，将在18个月后的随访访视期间重新进行行为调查模块和食物频率问卷调查，并将第二次收集人体测量指标。购买在家使用的食品和离家消费的食品的数据将与基于税收包裹数据的建筑环境的个人层面指标相关联。该研究的主要目的是评估SEP、环境和饮食变量对肥胖和体重增加的影响。假设低饮食质量和低饮食成本将与普遍肥胖相关，并将预测18个月。该模型将建立在根据目标2和3收集和验证的数据基础上。第二个目标是评估获得食物来源（物质和经济来源）、零售店选择和食物购买如何影响SEP各阶层的饮食质量。假设是，饮食质量将受到价格和其他经济变量的强烈影响，而不是接近食物来源。第三个目标将是验证自我报告的食物获取和支出数据，以客观衡量个人行为的空间和时间。该假设是基于GPS日志，食品商店和餐馆收据以及UPC扫描仪数据的食品购买行为的客观测量将为在不同地点获得的食品的能量和营养成分提供新的见解。研究结果有可能为地方和国家政策提供信息，以改善弱势群体获得负担得起的健康食品的零售渠道。

DESCRIPTION (provided by applicant): The Seattle Obesity Study (S.O.S) seeks to explain why obesity rates are more prevalent among some racial/ethnic minorities, population subgroups of lower education and incomes, and in high-poverty areas. The study will recruit a longitudinal cohort of 400 male and female adults, ages 21-65y, and resident in Seattle-King County and stratified by income and race/ethnicity, using an address-based sampling scheme. Data on food seeking behavior will be collected using a combination of self report and objective measures. At the first in- person interview, participants will complete a behavior survey module on food shopping and dietary habits, estimated food expenditures, nutrition literacy, attitudes towards diet and health, demographics, and health status. Health-related questions will address obesity, diabetes, stress, and cardiovascular disease. Height, weight, and waist circumference will be measured. A GPS receiver with data logging capability will be used to track the participants' movements and to record the time and location of all food-related events for 1 wk. Food store and restaurant receipts, stamped with time and date, will be collected for 4 wks. Foods brought into the home will be scanned with a portable UPC scanner for 4 wks. Three 24-h food recalls will be administered by phone in wks 3 and 4, and food frequency questionnaires will be administered in week 4 of data collection. To be able to establish causality between environmental and dietary variables and health outcomes, the behavior survey module and the food frequency questionnaire will be re-administered during a follow up visit 18 months later and anthropometric measures will be collected for the second time. Data on foods purchased for use at home and foods consumed away from home will be linked to individual-level metrics of the built environment based on tax parcel data. The main aim of the study is to assess the impact of SEP, environmental, and dietary variables on obesity and body weight gain. The hypothesis is that low dietary quality and low diet cost will be associated with prevalent obesity and will predict 18 mo. weight gain, adjusting for SEP. This model will be built on data collected and validated under Aims 2 and 3. The second aim will be to assess how access to food sources (both physical and economic), retail outlet choice, and food purchases impact diet quality across SEP strata. The hypothesis is that diet quality will be influenced strongly by price and other economic variables than by proximity to food sources. The third aim will be to validate self-reported data on food acquisition and expenditures against objective measures of individual behavior in space and time. The hypothesis is that objective measures of food purchase behaviors based on GPS logs, food store and restaurant receipts, and UPC scanner data will provide new insights into the energy and nutrient content of foods that are acquired at different locations. Study results have the potential of informing local and national policies on improving retail access to affordable healthy foods by vulnerable groups.