Real-time assessment of the food and social environments and dietary intakes in African American women

Background. While most research focuses on residential environment effects on diet and associated disparities, little is known about time-varying environmental influences. Linking time-stamped ecological momentary assessment (EMA) and dietary recall data, this study examined associations between the perceived food and social environments and diet in African American women.

Methods. Participants (n=101) were signaled five times daily for seven days to complete questions via smartphones on the food environment (e.g., food availability, food expense, proximity of food outlets) and social environment (e.g., stress, affect, who they were with) since the last signal, from which we developed both within-person and between-person variables. On up to three days, participants also completed 24-hour dietary recalls, from which we derived measures of calories, fat, sugar, and sodium, corresponding to the EMA reporting periods. Linear regression with random effects estimated associations controlling for demographics.

Results. Among the preliminary findings were that energy intake was significantly associated with being closer to a fast food restaurant/convenience store/bakery (113kcal), good-tasting, high-calorie food availability (276kcal), and eating with family (98kcal), relative to one’s usual proximity/level. Total fat intake was associated with good-tasting, high-calorie food availability (6.2g), talking on the phone (4.9g), and eating with family (5.1g). Some environmental factors were only associated with between-person differences in diet. For example, compared to other women, those who reported foods were more expensive or that no grocery store was nearby had higher energy intake and intakes of fat, sugar, and salt.

Discussion. Policies and environmental interventions may need to address exposures beyond the residential environment.