This project will examine how the physical, social, and economic environments influence dietary choices and, thereby, contribute to disparities in obesity rates. The present hypothesis is that the low cost and easy access to energy-dense foods may be an independent predictor of higher obesity rates. This study will combine survey research techniques with novel methods of spatial analysis to obtain in-depth information about the participants'physical and food environment and their access to food sources. A telephone survey of a stratified sample of 2,000 adult residents of King County, WA, will provide self-reported data on the participants'socioeconomic position (SEP), shopping and eating habits, food expenditures, obesity, and health. All addresses will be geocoded to facilitate spatial analysis and mapping. Objective measures of SEP will be based on data at the most detailed resolution available -- the County tax assessor at the tax parcel level. Objective measures of physical access to three key food sources, defined for each respondent in terms of quality, distance and time, will be calculated at the individual level using custom GIS based applications and novel metrics of the physical environment. Custom programs within GIS software will capture and perform preliminary geometric analysis of geospatial data within the proximity of the survey participants'home environment and their chief food sources. Dietary energy density and monetary cost of individual diets will be estimated using local food prices and an additional diet questionnaire instrument that will be mailed to all 2000 study respondents. Local variation in food prices will be assessed using a market basket technique. Spatial analyses and multilevel regression models will be used to test the hypothesis that physical and economic access to foods sources may predict dietary energy density and obesity rates.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
Project #
Application #
Study Section
Community Influences on Health Behavior (CIHB)
Program Officer
Everhart, James
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Washington
Public Health & Prev Medicine
Schools of Public Health
United States
Zip Code
Quistberg, D Alex; Howard, Eric J; Hurvitz, Philip M et al. (2017) The Relationship Between Objectively Measured Walking and Risk of Pedestrian-Motor Vehicle Collision. Am J Epidemiol 185:810-821
Schwartz, Michael W; Seeley, Randy J; Zeltser, Lori M et al. (2017) Obesity Pathogenesis: An Endocrine Society Scientific Statement. Endocr Rev 38:267-296
Tiwari, Arpita; Aggarwal, Anju; Tang, Wesley et al. (2017) Cooking at Home: A Strategy to Comply With U.S. Dietary Guidelines at No Extra Cost. Am J Prev Med 52:616-624
Drewnowski, Adam; Aggarwal, Anju; Tang, Wesley et al. (2016) Obesity, diet quality, physical activity, and the built environment: the need for behavioral pathways. BMC Public Health 16:1153
Aggarwal, Anju; Rehm, Colin D; Monsivais, Pablo et al. (2016) Importance of taste, nutrition, cost and convenience in relation to diet quality: Evidence of nutrition resilience among US adults using National Health and Nutrition Examination Survey (NHANES) 2007-2010. Prev Med 90:184-92
Tang, W; Aggarwal, A; Liu, Z et al. (2016) Validating self-reported food expenditures against food store and eating-out receipts. Eur J Clin Nutr 70:352-7
Tang, Wesley; Aggarwal, Anju; Moudon, Anne Vernez et al. (2016) Self-reported and measured weights and heights among adults in Seattle and King County. BMC Obes 3:11
Drewnowski, Adam; Aggarwal, Anju; Cook, Andrea et al. (2016) Drewnowski et al. respond. Prev Med 85:117-8
Seguin, Rebecca A; Aggarwal, Anju; Vermeylen, Francoise et al. (2016) Consumption Frequency of Foods Away from Home Linked with Higher Body Mass Index and Lower Fruit and Vegetable Intake among Adults: A Cross-Sectional Study. J Environ Public Health 2016:3074241
Drewnowski, Adam; Aggarwal, Anju; Cook, Andrea et al. (2016) Geographic disparities in Healthy Eating Index scores (HEI-2005 and 2010) by residential property values: Findings from Seattle Obesity Study (SOS). Prev Med 83:46-55

Showing the most recent 10 out of 47 publications