To compare the associations between food environment at the individual level, socioeconomic status (SES) and obesity rates in two cities: Seattle and Paris.
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.
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.
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
Open Access articles citing this article.
Ultra-processed foods and obesity and adiposity parameters among children and adolescents: a systematic review
European Journal of Nutrition Open Access 24 March 2022
International Journal of Behavioral Nutrition and Physical Activity Open Access 10 February 2022
International Journal of Obesity Open Access 17 February 2021
Subscribe to this journal
Receive 12 print issues and online access
$259.00 per year
only $21.58 per issue
Rent or buy this article
Prices vary by article type
Prices may be subject to local taxes which are calculated during checkout
Frumkin H . Urban sprawl and public health. Public Health Rep 2002; 117: 201–217.
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.
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.
Drewnowski A, Specter SE . Poverty and obesity: the role of energy density and energy costs. Am J Clin Nutr 2004; 79: 6–16.
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.
Adler NE, Rehkopf DH . U.S. disparities in health: descriptions, causes, and mechanisms. Annu Rev Public Health 2008; 29: 235–252.
McLaren L . Socioeconomic status and obesity. Epidemiol Rev 2007; 29: 29–48.
Adler NE, Newman K . Socioeconomic disparities in health: pathways and policies. Health Aff (Millwood) 2002; 21: 60–76.
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.
Drewnowski A, Darmon N . The economics of obesity: dietary energy density and energy cost. Am J Clin Nutr 2005; 82 (1 Suppl): 265S–273S.
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.
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.
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.
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.
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.
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.
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.
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.
Morland K, Diez Roux AV, Wing S . Supermarkets, other food stores, and obesity. Am J Prev Med 2006; 30: 333–339.
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.
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.
Ploeg MV . Access to Affordable, Nutritious Food is Limited in ‘Food Deserts’. USDA: Washington, DC, USA, 2010.
Gibson DM . The neighborhood food environment and adult weight status: estimates from longitudinal data. Am J Public Health 2011; 101: 71–78.
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.
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.
White M . Food access and obesity. Obes Rev 2007; 8: 99–107.
Larson N, Story M, Nelson M . Bringing Healthy Foods Home: Examining Inequalities in Access to Food Stores. Robert Wood Johnson Foundation, 2008.
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.
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.
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.
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.
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.
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.
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.
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.
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.
White M . Food access and obesity. Obes Rev 2007; 8 (Suppl 1): 99–107.
Charles MA, Eschwege E, Basdevant A . Monitoring the obesity epidemic in France: the Obepi surveys 1997–2006. Obesity (Silver Spring) 2008; 16: 2182–2186.
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.
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.
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.
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.
Friel S, Marmot MG . Action on the social determinants of health and health inequities goes global. Annu Rev Public Health 2011; 32: 225–236.
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.
Chaix B, Leal C, Evans D . Neighborhood-level confounding in epidemiologic studies: unavoidable challenges, uncertain solutions. Epidemiology 2011; 21: 124–127.
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.
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.
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.
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.
Monsivais P, Drewnowski A . The rising cost of low-energy-density foods. J Am Diet Assoc 2007; 107: 2071–2076.
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.
Zou G . A modified poisson regression approach to prospective studies with binary data. Am J Epidemiol 2004; 159: 702–706.
Devaux M, Sassi F . Social inequalities in obesity and overweight in 11 OECD countries. Eur J Public Health 2011; 23: 464–469.
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.
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.
Morland KB, Evenson KR . Obesity prevalence and the local food environment. Health Place 2009; 15: 491–495.
Jiao J, Moudon A, Drewnowski A . Grocery Shopping. Transportation Res Rec 2011; 2230: 85–95.
Kaufman P . Rural poor have less access to supermarkets, larger grocery stores. Rural Dev Perspect 1999; 13: 19–26.
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.
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.
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.
MacDonald JM . Do the poor still pay more? Food price variations in large metropolitan areas. J Urban Econ 1991; 30: 344–359.
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.
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.
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.
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.
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.
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.
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.
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).
The authors declare no conflict of interest.
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
This article is cited by
International Journal of Behavioral Nutrition and Physical Activity (2022)
Journal of Urban Health (2022)
Ultra-processed foods and obesity and adiposity parameters among children and adolescents: a systematic review
European Journal of Nutrition (2022)
International Journal of Obesity (2021)
Wiener klinische Wochenschrift (2020)