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种族/少数民族、教育程度和收入较低的人口亚群以及高度贫困地区更为普遍。该研究将采用基于地址的抽样方案，招募400名年龄在21-65岁之间、居住在西雅图金县、按收入和种族/民族分层的成年男女纵向队列。将采用自我报告和客观测量相结合的方法收集寻找食物行为的数据。在第一次面对面访谈中，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。测量身高、体重和腰围。一个具有数据记录功能的GPS接收器将用于跟踪参与者的活动，并记录一周内所有与食物有关的事件的时间和地点。食肆及食肆收据须于四个星期内收集，并加盖日期及时间戳。带回家的食物将用便携式UPC扫描仪扫描4周。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果之间的因果关系，行为调查模块和食物频率问卷将在18个月后的随访访问中重新进行管理，并将第二次收集人体测量数据。购买在家使用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，并将预测体重增加18万，调整SEP。该模型将建立在目标2和目标3收集和验证的数据基础上。第二个目标将是评估获得食物来源（物理和经济），零售店选择和食品购买如何影响SEP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，而不是食物来源的远近。第三个目标将是根据个人在空间和时间上的行为的客观衡量来验证关于粮食获取和支出的自我报告数据。其假设是，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含量提供新的见解。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.