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)试图解释为什么肥胖率在一些种族/民族少数群体、教育程度和收入较低的人群以及高度贫困地区更为普遍。这项研究将招募400名男性和女性成年人组成的纵向队列，年龄在21-65岁之间，居住在西雅图-金县，按收入和种族/民族分层，采用基于地址的抽样方案。关于觅食行为的数据将使用自我报告和客观措施相结合的方式收集。在第一次面谈中，参与者将完成关于食品购物和饮食习惯、估计食品支出、营养素养、对饮食和健康的态度、人口统计学和健康状况的行为调查模块。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行动，并记录所有与食物有关的事件的时间和地点，为期1周。食品店和餐馆的收据，印有时间和日期，将在4周内收集。携带到家里的食物将用便携式UPC扫描仪扫描4周。在第三周和第四周将通过电话进行三次24小时食品召回，在数据收集的第四周将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果之间的因果关系，将在18个月后的后续访问中重新执行行为调查模块和食物频率问卷，并将第二次收集人体测量数据。关于在家中购买的食品和外出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水平指标联系起来。这项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存在的肥胖症相关，并将预测18mo。体重增加，根据SEP进行调整。该模型将建立在目标2和目标3中收集和验证的数据的基础上。第二个目标将评估获得食品来源(物质和经济)、零售网点选择和食品购买如何影响SEP各阶层的饮食质量。这个假设是，饮食质量将受到价格和其他经济变量的强烈影响，而不是受接近食物来源的影响。第三个目标将是对照个人在空间和时间上行为的客观衡量标准来验证自我报告的食物获取和支出数据。这个假设是，基于GPS日志、食品商店和餐厅收据以及UPC扫描仪数据对食品购买行为的客观衡量，将为在不同地点获得的食品的能量和营养含量提供新的见解。研究结果有可能为地方和国家关于改善弱势群体获得负担得起的健康食品的零售机会的政策提供信息。 公共卫生相关性：更好地了解可能解释饮食质量和慢性病方面的社会差异的因素至关重要。这项拟议的纵向研究试图解释建筑环境、经济、心理社会因素、SEP和人口统计学因素对食物寻找行为、饮食质量、肥胖和体重增加的作用。这个关于建筑环境、行为和健康的跨学科项目汇集了来自营养学、地理学、流行病学、医学、统计学和城市设计的专家。

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. PUBLIC HEALTH RELEVANCE: A better understanding of factors that may explain social disparities in diet quality and chronic diseases is critical. The proposed longitudinal study seeks to explain the role of built environment, economics, psychosocial factors, SEP and demographics on food seeking behaviors, diet quality, obesity and body weight gain. This interdisciplinary project on the built environment, behavior and health brings together experts from nutrition, geography, epidemiology, medicine, statistics and urban design.