Navigating the complexities of time use, food patterns and obesity

Obesity is a public health problem that requires a range of solutions related to individual diet and activity, and food and built environment. Examination of complex relationships between food choice, time-use patterns, socio-demographic characteristics and obesity has been limited by data availability and disciplinary focus. Using a “health production” model this study links nationally representative data from the National Health and Nutrition Examination and the American Time Use Surveys to provide a more complete picture of the impact of food and time use patterns on obesity using a two step multivariate recursive regression model. In the model, people “produce” a health weight by combining food intake and activity outputs. This economist's approach to obesity mirrors the nutritionist's energy balance equation. Variables that impact the probability of being overweight and that predict BMI for overweight and normal weight individuals differ in significance, magnitude, and direction of effect. While race and income are significant in the models, lifestyle pattern clusters of time use and food patterns also are also related to both the probability of being overweight and BMI. Individual time use patterns related to food preparation and time spent eating impact BMI in different directions for normal versus overweight individuals. A transdisciplinary approach that includes methods and measures previously utilized by either nutrition experts or economists provides a framework the investigation of some of the complexities involved in studying lifestyle factors related to obesity. Results parallel findings from more targeted studies and suggest interventions that related to time use and activity.