Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Food environment and socioeconomic status influence obesity rates in Seattle and in Paris

International Journal of Obesity volume 38, pages 306–314 (2014)Cite this article

Subjects

Abstract

Objective:

To compare the associations between food environment at the individual level, socioeconomic status (SES) and obesity rates in two cities: Seattle and Paris.

Methods:

Analyses of the SOS (Seattle Obesity Study) were based on a representative sample of 1340 adults in metropolitan Seattle and King County. The RECORD (Residential Environment and Coronary Heart Disease) cohort analyses were based on 7131 adults in central Paris and suburbs. Data on sociodemographics, health and weight were obtained from a telephone survey (SOS) and from in-person interviews (RECORD). Both studies collected data on and geocoded home addresses and food shopping locations. Both studies calculated GIS (Geographic Information System) network distances between home and the supermarket that study respondents listed as their primary food source. Supermarkets were further stratified into three categories by price. Modified Poisson regression models were used to test the associations among food environment variables, SES and obesity.

Results:

Physical distance to supermarkets was unrelated to obesity risk. By contrast, lower education and incomes, lower surrounding property values and shopping at lower-cost stores were consistently associated with higher obesity risk.

Conclusion:

Lower SES was linked to higher obesity risk in both Paris and Seattle, despite differences in urban form, the food environments and in the respective systems of health care. Cross-country comparisons can provide new insights into the social determinants of weight and health.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Frumkin H . Urban sprawl and public health. Public Health Rep 2002; 117: 201–217.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Rundle A, Neckerman KM, Freeman L, Lovasi GS, Purciel M, Quinn J et al. Neighborhood food environment and walkability predict obesity in New York City. Environ Health Perspect 2009; 117: 442–447.

    Article  PubMed  Google Scholar 

  3. Richard L, Gauvin L, Raine K . Ecological models revisited: their uses and evolution in health promotion over two decades. Annu Rev Public Health 2011; 32: 307–326.

    Article  PubMed  Google Scholar 

  4. Drewnowski A, Specter SE . Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004; 79: 6–16.

    Article  CAS  PubMed  Google Scholar 

  5. Zhang Q, Wang Y . Trends in the association between obesity and socioeconomic status in U.S. adults: 1971 to 2000. Obes Res 2004; 12: 1622–1632.

    Article  PubMed  Google Scholar 

  6. Adler NE, Rehkopf DH . U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health 2008; 29: 235–252.

    Article  PubMed  Google Scholar 

  7. McLaren L . Socioeconomic status and obesity. Epidemiol Rev 2007; 29: 29–48.

    Article  PubMed  Google Scholar 

  8. Adler NE, Newman K . Socioeconomic disparities in health: pathways and policies. Health Aff (Millwood) 2002; 21: 60–76.

    Article  Google Scholar 

  9. Mendoza JA, Drewnowski A, Christakis DA . Dietary energy density is associated with obesity and the metabolic syndrome in U.S. adults. Diabetes Care 2007; 30: 974–979.

    Article  PubMed  Google Scholar 

  10. Drewnowski A, Darmon N . The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr 2005; 82 (1 Suppl): 265S–273S.

    Article  CAS  PubMed  Google Scholar 

  11. Ledikwe JH, Blanck HM, Khan LK, Serdula MK, Seymour JD, Tohill BC et al. Dietary energy density is associated with energy intake and weight status in US adults. Am J Clin Nutr 2006; 83: 1362–1368.

    Article  CAS  PubMed  Google Scholar 

  12. Swinburn BA, Caterson I, Seidell JC, James WP . Diet, nutrition and the prevention of excess weight gain and obesity. Public Health Nutr 2004; 7: 123–146.

    CAS  PubMed  Google Scholar 

  13. Kant AK, Graubard BI . Energy density of diets reported by American adults: association with food group intake, nutrient intake, and body weight. Int J Obes (Lond) 2005; 29: 950–956.

    Article  CAS  Google Scholar 

  14. Perrin AE, Simon C, Hedelin G, Arveiler D, Schaffer P, Schlienger JL . Ten-year trends of dietary intake in a middle-aged French population: relationship with educational level. Eur J Clin Nutr 2002; 56: 393–401.

    Article  CAS  PubMed  Google Scholar 

  15. Darmon N, Ferguson EL, Briend A . Impact of a cost constraint on nutritionally adequate food choices for French women: an analysis by linear programming. J Nutr Educ Behav 2006; 38: 82–90.

    Article  PubMed  Google Scholar 

  16. Méjean C, Macouillard P, Castetbon K, Kesse-Guyot E, Hercberg S . Socio-economic, demographic, lifestyle and health characteristics associated with consumption of fatty-sweetened and fatty-salted foods in middle-aged French adults. Br J Nutr 2011; 105: 776–786.

    Article  PubMed  Google Scholar 

  17. Bodor JN, Rice JC, Farley TA, Swalm CM, Rose D . The Association between obesity and urban food environments. J Urban Health 2010; 87: 771–781.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Larson NI, Story MT, Nelson MC . Neighborhood environments: disparities in access to healthy foods in the U.S. Am J Prev Med 2009; 36: 74–81.

    Article  PubMed  Google Scholar 

  19. Morland K, Diez Roux AV, Wing S . Supermarkets, other food stores, and obesity. Am J Prev Med 2006; 30: 333–339.

    Article  PubMed  Google Scholar 

  20. Treuhaft S, Karpyn A . The Grocery Gap: Who has access to healthy food and why it matters. Policy Link and The Food Trust: Oakland, CA, 2010.

  21. Laska MN, Hearst MO, Forsyth A, Pasch KE, Lytle L . Neighbourhood food environments: are they associated with adolescent dietary intake, food purchases and weight status? Public Health Nutr 2010; 13: 1757–1763.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ploeg MV . Access to Affordable, Nutritious Food is Limited in ‘Food Deserts’. USDA: Washington, DC, USA, 2010.

    Google Scholar 

  23. Gibson DM . The neighborhood food environment and adult weight status: estimates from longitudinal data. Am J Public Health 2011; 101: 71–78.

    Article  PubMed  PubMed Central  Google Scholar 

  24. Moore LV, Diez Roux AV, Nettleton JA, Jacobs DR Jr . Associations of the local food environment with diet quality—a comparison of assessments based on surveys and geographic information systems: the multi-ethnic study of atherosclerosis. Am J Epidemiol 2008; 167: 917–924.

    Article  PubMed  Google Scholar 

  25. Leal C, Bean K, Thomas F, Chaix B . Are associations between neighborhood socioeconomic characteristics and body mass index or waist circumference based on model extrapolations? Epidemiology 2011; 22: 694–703.

    Article  PubMed  Google Scholar 

  26. White M . Food access and obesity. Obes Rev 2007; 8: 99–107.

    Article  PubMed  Google Scholar 

  27. Larson N, Story M, Nelson M . Bringing Healthy Foods Home: Examining Inequalities in Access to Food Stores. Robert Wood Johnson Foundation, 2008.

    Google Scholar 

  28. Michimi A, Wimberly MC . Associations of supermarket accessibility with obesity and fruit and vegetable consumption in the conterminous United States. Int J Health Geogr 2010; 9: 49.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Wang MC, Cubbin C, Ahn D, Winkleby MA . Changes in neighbourhood food store environment, food behaviour and body mass index, 1981–1990. Public Health Nutr 2008; 11: 963–970.

    Article  PubMed  Google Scholar 

  30. Leung CW, Laraia BA, Kelly M, Nickleach D, Adler NE, Kushi LH et al. The influence of neighborhood food stores on change in young girls' body mass index. Am J Prev Med 2011; 41: 43–51.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Charreire H, Casey R, Salze P, Simon C, Chaix B, Banos A et al. Measuring the food environment using geographical information systems: a methodological review. Public Health Nutr 2010; 13: 1773–1785.

    Article  PubMed  Google Scholar 

  32. Drewnowski A, Aggarwal A, Hurvitz PM, Monsivais P, Moudon AV . Obesity and supermarket access: proximity or price? Am J Public Health 2012; 102: e74–e80.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Chaix B, Bean K, Daniel M, Zenk SN, Kestens Y, Charreire H et al. Associations of supermarket characteristics with weight status and body fat: a multilevel analysis of individuals within supermarkets (RECORD study). PLoS One 2012; 7: e32908.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Boone-Heinonen J, Gordon-Larsen P, Kiefe CI, Shikany JM, Lewis CE, Popkin BM . Fast food restaurants and food stores: longitudinal associations with diet in young to middle-aged adults: the CARDIA study. Arch Intern Med 2011; 171: 1162–1170.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Aggarwal A, Monsivais P, Drewnowski A . Nutrient intakes linked to better health outcomes are associated with higher diet costs in the US. PloS One 2012; 7: e37533.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  36. Moudon AV, Cook AJ, Ulmer J, Hurvitz PM, Drewnowski A . A neighborhood wealth metric for use in health studies. Am J Prev Med 2011; 41: 88–97.

    Article  PubMed  PubMed Central  Google Scholar 

  37. White M . Food access and obesity. Obes Rev 2007; 8 (Suppl 1): 99–107.

    Article  PubMed  Google Scholar 

  38. Charles MA, Eschwege E, Basdevant A . Monitoring the obesity epidemic in France: the Obepi surveys 1997–2006. Obesity (Silver Spring) 2008; 16: 2182–2186.

    Article  Google Scholar 

  39. Flegal KM, Carroll MD, Kit BK, Ogden CL . Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999–2010. JAMA 2012; 307: 491–497.

    Article  PubMed  Google Scholar 

  40. Turrell G, Hewitt B, Patterson C, Oldenburg B . Measuring socio-economic position in dietary research: is choice of socio-economic indicator important? Public Health Nutr 2003; 6: 191–200.

    PubMed  Google Scholar 

  41. Thomas F, Bean K, Pannier B, Oppert JM, Guize L, Benetos A . Cardiovascular mortality in overweight subjects: the key role of associated risk factors. Hypertension 2005; 46: 654–659.

    Article  CAS  PubMed  Google Scholar 

  42. Wang MC, Kim S, Gonzalez AA, MacLeod KE, Winkleby MA . Socioeconomic and food-related physical characteristics of the neighbourhood environment are associated with body mass index. J Epidemiol Community Health 2007; 61: 491–498.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Friel S, Marmot MG . Action on the social determinants of health and health inequities goes global. Annu Rev Public Health 2011; 32: 225–236.

    Article  PubMed  Google Scholar 

  44. Aggarwal A, Monsivais P, Cook AJ, Drewnowski A . Does diet cost mediate the relation between socioeconomic position and diet quality? Eur J Clin Nutr 2011; 65: 1059–1066.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. Chaix B, Leal C, Evans D . Neighborhood-level confounding in epidemiologic studies: unavoidable challenges, uncertain solutions. Epidemiology 2011; 21: 124–127.

    Article  Google Scholar 

  46. Chaix B, Kestens Y, Bean K, Leal C, Karusisi N, Meghiref K et al. Cohort profile: residential and non-residential environments, individual activity spaces and cardiovascular risk factors and diseases—The RECORD Cohort Study. Int J Epidemiol 2011; 41: 1283–1292.

    Article  PubMed  Google Scholar 

  47. Chaix B, Jouven X, Thomas F, Leal C, Billaudeau N, Bean K et al. Why socially deprived populations have a faster resting heart rate: impact of behaviour, life course anthropometry, and biology—the RECORD Cohort Study. Soc Sci Med 2011; 73: 1543–1550.

    Article  PubMed  Google Scholar 

  48. Chaix B, Bean K, Leal C, Thomas F, Havard S, Evans D et al. Individual/neighborhood social factors and blood pressure in the RECORD Cohort Study: which risk factors explain the associations? Hypertension 2010; 55: 769–775.

    Article  CAS  PubMed  Google Scholar 

  49. Charreire H, Weber C, Chaix B, Salze P, Casey R, Banos A et al. Identifying built environmental patterns using cluster analysis and GIS: relationships with walking, cycling and body mass index in French adults. Int J Behav Nutr Phys Activity 2012; 9: 59.

    Article  Google Scholar 

  50. Monsivais P, Drewnowski A . The rising cost of low-energy-density foods. J Am Diet Assoc 2007; 107: 2071–2076.

    Article  PubMed  Google Scholar 

  51. Mahmud NK, Monsivais P, Drewnowski A . The Search for Affordable Nutrient Rich Foods: A Comparison of Supermarket Food Prices in Seattle-King County. Center for Public Health Nutrition, University of Washington, 2009.

    Google Scholar 

  52. Zou G . A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004; 159: 702–706.

    Article  PubMed  Google Scholar 

  53. Devaux M, Sassi F . Social inequalities in obesity and overweight in 11 OECD countries. Eur J Public Health 2011; 23: 464–469.

    Article  PubMed  Google Scholar 

  54. Powell LM, Auld MC, Chaloupka FJ, O'Malley PM, Johnston LD . Associations between access to food stores and adolescent body mass index. Am J Prev Med 2007; 33: S301–S307.

    Article  PubMed  Google Scholar 

  55. Morland K, Wing S, Roux AD . The contextual effect of the local food environment on residents’ diets: the Atherosclerosis Risk in Communities Study. Am J Public Health 2002; 92: 1761–1767.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Morland KB, Evenson KR . Obesity prevalence and the local food environment. Health Place 2009; 15: 491–495.

    Article  PubMed  Google Scholar 

  57. Jiao J, Moudon A, Drewnowski A . Grocery Shopping. Transportation Res Rec 2011; 2230: 85–95.

    Article  Google Scholar 

  58. Kaufman P . Rural poor have less access to supermarkets, larger grocery stores. Rural Dev Perspect 1999; 13: 19–26.

    Google Scholar 

  59. Zenk SN, Schulz AJ, Israel BA, James SA, Bao S, Wilson ML . Neighborhood racial composition, neighborhood poverty, and the spatial accessibility of supermarkets in metropolitan Detroit. Am J Public Health 2005; 95: 660–667.

    Article  PubMed  PubMed Central  Google Scholar 

  60. Franco M, Diez Roux AV, Glass TA, Caballero B, Brancati FL . Neighborhood characteristics and availability of healthy foods in Baltimore. Am J Prev Med 2008; 35: 561–567.

    Article  PubMed  PubMed Central  Google Scholar 

  61. Chung C, Myers S . Do the poor pay more for food? An analysis of grocery store availability and food price disparities. J Consumer Aff 1999; 33: 276–296.

    Article  Google Scholar 

  62. MacDonald JM . Do the poor still pay more? Food price variations in large metropolitan areas. J Urban Econ 1991; 30: 344–359.

    Article  Google Scholar 

  63. White M, Bunting J, Williams L, Raybould S, Adamson A, Mathers J . Do Food Deserts Exist? A Multilevel Geographical Analysis of the Relationship Between Retail Food Access, Socioeconomic Position and Dietary Intake. University of Newcastle, 2002.

    Google Scholar 

  64. Jiao J, Moudon AV, Ulmer J, Hurvitz PM, Drewnowski A . How to identify food deserts: measuring physical and economic access to supermarkets in King County, Washington. Am J Public Health 2012; 102: e32–e39.

    Article  PubMed  PubMed Central  Google Scholar 

  65. Carlson A, Frazao E Are healthy foods really more expensive? It depends on how you measure the price, EIB-96. In: Agriculture UDo, (ed): Economic Research Service: Washington, DC 2012.

  66. Caspi CE, Kawachi I, Subramanian SV, Adamkiewicz G, Sorensen G . The relationship between diet and perceived and objective access to supermarkets among low-income housing residents. Soc Sci Med 2012; 75: 1254–1262.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Drewnowski A, Fiddler EC, Dauchet L, Galan P, Hercberg S . Diet quality measures and cardiovascular risk factors in France: applying the Healthy Eating Index to the SU.VI.MAX study. J Am Coll Nutr 2009; 28: 22–29.

    Article  PubMed  Google Scholar 

  68. Rozin P, Fischler C, Shields C, Masson E . Attitudes towards large numbers of choices in the food domain: a cross-cultural study of five countries in Europe and the USA. Appetite 2006; 46: 304–308.

    Article  PubMed  Google Scholar 

  69. Rozin P, Remick AK, Fischler C . Broad themes of difference between French and Americans in attitudes to food and other life domains: personal versus communal values, quantity versus quality, and comforts versus joys. Front Psychol 2011; 2: 177.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

The Seattle Obesity Study (SOS) was supported by NIH Grant R01DK076608 on food environment and disparities in obesity and by NIH Grant R21 DK085406. The RECORD study in Paris was supported by l’Institut de Recherche en Santé Publique (IReSP), l’Institut National de Prévention et d’Education à la Santé (INPES), l’Institut de Veille Sanitaire (InVS), les Ministères de la Santé et de la Recherche, l’Agence Nationale de la Recherche (ANR), le Groupement Régional de Santé Publique (GRSP) d’Île-de-France, la Direction Régionale des Affaires Sanitaires et Sociales d’Île-de-France (DRASSIF), la Direction Régionale de la Jeunesse et des Sports d’Île-de-France (DRDJS) and le Conseil Régional d’Île358 de-France and by l’Ecole des Hautes Etudes en Santé Publique (EHESP).

Author information

Authors and Affiliations

  1. Center for Public Health Nutrition, University of Washington, Seattle, WA, USA

    A Drewnowski & A Aggarwal

  2. Urban Form Lab, College of Built Environments, University of Washington, Seattle, WA, USA

    A V Moudon

  3. School of Architecture, University of Texas, Austin, TX, USA

    J Jiao

  4. UMR Inserm U557; Inra U1125; Cnam; University Paris 13-Sorbonne Paris Cité, CRNH Ile-de-France,

    H Charreire

  5. Inra U1125, Bobigny, France

    H Charreire

  6. Department of Geography, Lab-Urba, Urbanism Institute of Paris, University Paris-Est, Paris, France

    H Charreire

  7. Inserm, U707, Paris, France

    B Chaix

  8. Université Pierre et Marie Curie-Paris 6, UMR-S 707, Paris, France

    B Chaix

Authors
  1. A Drewnowski
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. A V Moudon
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Jiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. A Aggarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. H Charreire
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. B Chaix
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to A Drewnowski.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Drewnowski, A., Moudon, A., Jiao, J. et al. Food environment and socioeconomic status influence obesity rates in Seattle and in Paris. Int J Obes 38, 306–314 (2014). https://doi.org/10.1038/ijo.2013.97

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ijo.2013.97

Keywords

This article is cited by

Search

Advanced search

Quick links