People don’t gain or lose weight because they live near a fast-food restaurant or supermarket, according to a new led by the 91±¬ÁĎ. And, living in a more “walkable,” dense neighborhood likely only has a small impact on weight.

These “built-environment” amenities have been seen in as essential contributors to losing weight or tending toward obesity. The idea appears obvious: If you live next to a fast-food restaurant, you’ll eat there more and thus gain weight. Or, if you have a supermarket nearby, you’ll shop there, eat healthier and thus lose weight. Live in a neighborhood that makes walking and biking easier and you’ll get out, exercise more and burn more calories.

The new study based on anonymized medical records from more than 100,000 Kaiser Permanente Washington patients did not find that living near supermarkets or fast-food restaurant had any impact on weight. However, urban density, such as the number of houses in a given neighborhood, which is closely linked to neighborhood “walkability” appears to be the strongest element of the built environment linked to change in body weight over time.

“There’s a lot of prior work that has suggested that living close to a supermarket might lead to lower weight gain or more weight loss, while living close to lots of fast-food restaurants might lead to weight gain,” said , lead author of the study and a research scientist in the 91±¬ÁĎ School of Public Health. “Our analyses of the food environment and density together suggests that the more people there are in an area — higher density — the more supermarkets and fast-food restaurants are located there. And we found that density matters to weight gain, but not proximity to fast food or supermarkets. So, that seems to suggest that those other studies were likely observing a false signal.”

The 91±¬ÁĎ-led study, published earlier this month in the International Journal of Obesity, found that people living in neighborhoods with higher residential and population density weigh less and have less obesity than people living in less-populated areas. And that didn’t change over a five-year period of study.

“On the whole, when thinking about ways to curb the obesity epidemic, our study suggests there’s likely no simple fix from the built environment, like putting in a playground or supermarket,” said Buszkiewicz, who did his research for the study while a graduate student in the 91±¬ÁĎ Department of Epidemiology.

Rather than “something magical about the built environment itself” influencing the weight of those individuals, Buszkiewicz said, community-level differences in obesity are more likely driven by systematic factors other than the built environment — such as income inequality, which is often the determining factor of where people can afford to live and whether they can afford to move.

“Whether you can afford to eat a healthy diet or to have the time to exercise, those factors probably outweigh the things we’re seeing in terms of the built environment effect,” he said.

The researchers used the Kaiser Permanente Washington records to gather body weight measurements several times over a five-year period. They also used geocodable addresses to establish neighborhood details, including property values to help establish socioeconomic status, residential unit density, population density, road intersection density, and counts of supermarkets and fast-food restaurants accessible within a short walk or drive.

“This study really leverages the power of big data,” said Dr. David Arterburn, co-author and senior investigator at Kaiser Permanente Washington Health Research Institute. “Our use of anonymized health care records allows us to answer important questions about environmental contributions to obesity that would have been impossible in the past.”

This study is part of a 12-year, joint 91±¬ÁĎĚý˛ą˛Ô»ĺĚýKaiser Permanente Washington research project called Moving to Health. The goal of the study, according to the 91±¬ÁĎ’s , is to provide population-based, comprehensive, rigorous evidence for policymakers, developers and consumers regarding the features of the built environment that are most strongly associated with risk of obesity and diabetes.

“Our next goal is to better understand what happens when people move their primary residence from one neighborhood to another,” Arterburn said. “When our neighborhood characteristics change rapidly — such as moving to a much more walkable residential area — does that have an important effect on our body weight?”

Co-authors include Jennifer Bobb, Andrea Cook, Maricela Cruz, Paula Lozano, Dori Rosenberg, Mary Kay Theis and Jane Anau at Kaiser Permanente Washington Health Research Institute; , 91±¬ÁĎ Urban Form Lab, College of Built Environments; , 91±¬ÁĎ Department of Epidemiology; , 91±¬ÁĎ Urban Form Lab and Center for Studies in Demography and Ecology; and , 91±¬ÁĎ Center for Public Health Nutrition and Department of Epidemiology. This research manuscript was supported by grants from the National Institutes of Health: 1 R01 DK 114196, 5 R01 DK076608, and 4 R00LM012868.

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For more information, contact Buszkiewicz at buszkiew@uw.edu  and Caroline Liou Caroline.X.Liou@kp.org

Understanding Washington residents’ access to food and their economic well-being – or lack of it – during the COVID-19 pandemic is vital for state and community partners to identify those needs and allocate resources effectively.

To help accomplish this goal, the 91±¬ÁĎ, Washington State University and Tacoma Community College, along with input from partners in local, county and state governments — such as the Washington State Department of Health and the Washington State Department of Agriculture — are conducting a series of .

The first wave of this series of surveys was conducted in June and July, and 2,621 Washington residents from 38 of 39 counties responded. Now researchers are recruiting participants in the survey’s second wave.

“The first survey found that food insecurity was high among state residents, and that the majority of food insecure households had children. We also found disparities in the burden of food insecurity by income, race, ethnicity and educational attainment,” said , one of the leaders of the survey team and a 91±¬ÁĎ associate professor of environmental and occupational health sciences at the School of Public Health.

Specifically, the first wave of the found:

• Food insecurity was high, alarmingly so, in the summer following the state shutdown, affecting an estimated 30% of households, exacerbating pre-existing social inequities.
• Highest rates of food insecurity – 58% – were observed among households below the poverty line.
• Households having members with some or no college education were also disproportionately impacted with 44% of respondents experiencing food insecurity.
• 42% of respondents of color experienced food insecurity.
• About 40% of all survey participants reported that their diet got worse.
• Participants reported being concerned about safety in supermarkets and grocery stores, rising food costs, access and transportation.
• Post Covid-19 diets had more eggs, rice, beans, pasta and peanut butter but less meat, seafood and milk and dairy.
• Store bought cakes and cookies decreased but there was a sharp increase in cooking at home.

“Our findings also helped to characterize which and how food assistance programs were working for Washington residents as well as where additional changes might be needed to better support their food needs. Public agencies and anti-hunger networks held the survey up as useful in informing their programs and distribution and outreach needs,” Otten said.

Complete results of the first survey are available .

The second wave of the currently is underway and runs until mid-January.

Survey questions ask about access to food and food assistance, employment conditions and financial needs, as well as diet quality and health. The survey takes about 15 minutes or less to complete and is open to all Washington State residents age 18 years or older.

“Wave 2 will monitor the continuing impact of the pandemic on economic- and food-related wellbeing eight months after the initial lockdown. We hope to continue to add more waves of data collection to monitor the ongoing situation,” Otten said. “The data collected will be used by legislators, public agencies and anti-hunger networks to allocate resources, provide support and promote the recovery of Washington residents.”

The 91±¬ÁĎ team included School of Public Health faculty and staff: , , ;Ěý,Ěý,ĚýĚý˛ą˛Ô»ĺĚý, all affiliated with the 91±¬ÁĎ Center for Public Health Nutrition. Washington State University was represented by , director of the Food Systems Program, and Tacoma Community College by , professor of health, business and profession services. This project is supported by a charitable donation from the Ballmer Group.

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For more information, contact Otten at jotten@uw.edu.

The , which went live June 18 and runs through July 31, is open to all Washington state residents aged 18 or over. It was created by researchers at the 91±¬ÁĎ, Washington State University and Tacoma Community College, along with input from partners in local, county and state governments — such as the Washington State Department of Health and the Washington State Department of Agriculture.

“We know from increased demand at food banks and in food assistance programs that there has been a steep increase in food insecurity, but we don’t know the details. How are needs changing?” said , one of the leaders of the survey team and a 91±¬ÁĎ associate professor of environmental and occupational health sciences. “In addition, due to physical distancing and changes in shopping patterns and food availability, it’s clear that some are also likely experiencing radical dietary shifts.”

The survey, which takes about 20 minutes to complete, asks participants questions about their access to food and levels of economic security and about dietary shifts. It does not ask participants for identifiable information, such as names or protected health information.

“The information gathered by this survey will help state and community partners understand what people are experiencing and help with resource allocation for Washington state residents,” said Otten. “It’s very important we hear from everyone about what has changed, what has stayed the same, and what would help.”

Food insecurity generally encompasses all the factors that keep people from accessing sufficient food and nutrition, including economic, social and employment factors — as well as government and community-assistance factors and issues related to food distribution and infrastructure. National data indicate since the coronavirus pandemic began.

The new survey is intended provide an in-depth look at both food and economic security in Washington state — one of the first states to enact social distancing measures, including limiting crowd sizes and closing certain businesses and venues.

“The goals of this survey are to understand how Washington residents are coping with disruptions in economic activity, as well as food distribution and access,” said , another survey team leader and a 91±¬ÁĎ professor of epidemiology.

The team is particularly interested in responses from low-income households and those households that are underserved by food assistance programs. They plan to analyze survey responses on both a statewide level, as well as local and regional levels using participant-provided ZIP codes.

Researchers will share the information gathered by the survey with government and community partners to help identify needs related to food security and allocate resources accordingly.

The survey is available in both English and Spanish here:

Participants also have the option of entering drawings for $50 grocery store gift cards.

Additional 91±¬ÁĎ team members include , assistant professor of environmental and occupational health sciences; and , research coordinators with the 91±¬ÁĎ Nutritional Sciences Program; doctoral student ; and undergraduate student . Survey team leaders also include Laura Lewis, an associate professor of community and economic development at WSU and director of the Food Systems Program, as well as , professor of health, business and professional services at Tacoma Community College. 91±¬ÁĎ funding is provided by the university’s Population Health Initiative, the Department of Epidemiology and the School of Public Health.

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For more information, contact Otten at jotten@uw.edu and Drewnowski at adamdrew@uw.edu.

In the Pacific Northwest, the conversation about hydroelectric dams is complicated: Dams hamper the natural migration of salmon, yet they are an important source of cheap, renewable energy for the region.

In other parts of the world, gray areas still exist, but the conversation about dams is very different, brought on by a critical need for reliable food and energy sources. In tropical river systems such as the Amazon, Congo and the Mekong, river and lake fishing provide food security in some of the world’s poorest regions and would be negatively impacted by an onslaught of new dams. At the same time, existing and future dams planned on these rivers hold the promise of renewable energy in places that arguably need it the most.

There, the debate is over when and how — not whether — dams will be built and operated.

In Southeast Asia, the Mekong River and its tributaries support what is likely the largest inland fishery in the world, worth more than $2 billion annually, that over 60 million people rely on for daily food and livelihoods. Nearly 100 hydropower dams are planned for construction along the tributaries and main stem of the river’s 2,700-mile stretch.

In a , researchers from the 91±¬ÁĎ, Arizona State University and others institutions that allows dam operators to generate power in ways that also protect — and possibly improve — food supplies and businesses throughout the Mekong River basin. The proposed solution, the first of its kind, can be applied to other large river systems around the world facing similar tradeoffs.

“One of the challenges in dealing with these systems and environmental change is the conversation is largely stuck in, ‘don’t build dams,’ or ‘yes, build dams,'” said , a 91±¬ÁĎ assistant professor of aquatic and fishery sciences. “What this does say is, let’s try to find ways we can work together. This won’t solve all the problems, but let’s work to find solutions.”

The paper represents a first step in a large, multiyear project involving researchers across the 91±¬ÁĎ and ASU campuses. Funded by the National Science Foundation’s , the project will use findings in the Mekong River basin as an example of how three critical issues — feeding people, generating energy and maintaining functioning ecosystems — can be addressed thoughtfully and progressively in the developing world.

Every summer in the Mekong River basin, monsoon rains flood the river and delta, increasing by six times the flooded area of Cambodia’s Tonle Sap Lake, the largest lake in Southeast Asia and frequently called the “heart” of the Mekong. The rise and eventual fall of the water triggers the migration of dozens of fish species, which spawn in the upper tributaries during low water. Fish larvae return to the lake on the next flood to grow and mature in its highly productive waters. This yearly pattern provides a critical source of animal protein, and an economy, for the people of Cambodia and other countries along the Lower Mekong.

But with new dams coming online soon, there is no basin-wide effort to coordinate how each dam’s release of water will impact the hydrology of the basin or fish, said , a 91±¬ÁĎ professor of civil and environmental engineering and a collaborator on the project.

The goal of the project, involving researchers from fisheries, forestry, engineering, public health and the , is to gather information about how dam water flow interacts with fish, rice production and nutrition in this region and provide the most useful information to individual countries so that they can decide how best to operate their hydropower dams, he explained.

“We are trying to find a sweet spot for the many stakeholders, who often compete for resources, that can maximize the overall benefits in a way that doesn’t do too much damage to the environment, fish and livelihood of the region,” Hossain said.

One promising option is to use hydroelectric dams to mimic the flood of water from monsoon rains each spring that bring fish to the lake. The team’s algorithm, outlined in the Science paper, recommends long, low-flow periods punctuated by rapid flooding, which would allow dam operators to manage their power generation priorities while protecting fishing economies downstream.

The researchers found that seasonal periods of drought before the annual flood are crucial to producing abundant fisheries in the lake and surrounding streams. When the soil is dry, trees and plants grow, organic matter is produced and the soil is filled with nutrients. When floodwaters rush in, those nutrients are suspended in the water and fish are able to exploit them — drawing more fish to the feast, which in turn benefits fishers.

Holtgrieve, along with several 91±¬ÁĎ colleagues, will study the flooding cycle in connection with the nutritional value of fish and rice, both staples in Southeast Asian diets, to help prioritize certain species and timing for harvesting the most nutritious food. Specifically, he will analyze tissue samples from 50 different fish species covering a range of habitats in the Mekong, measuring for beneficial fatty acids, vitamins and minerals, as well as for harmful elements like mercury.

“We as a society view fish as generally good for you,” Holtgrieve said. “This project recognizes that not all fish are the same in terms of their nutritional value.”

With the knowledge of which fish are the healthiest to eat, the researchers can work backward by figuring out what those fish like to eat, and then what flood and drought regime is most likely to produce those plants and organisms — controlled by dams releasing water — that produce more fish of high nutritional value.

Similarly, 91±¬ÁĎ professors (civil and environmental engineering) and (environmental and forest sciences) will look at beneficial nutrients, such as zinc, and harmful contaminants, such as arsenic, in rice to measure whether the length of time that rice paddies are flooded makes a difference in the presence of these elements in the crop. Again, water releases from hydropower dams could be programmed to optimize for rice that is high in zinc and low in arsenic.

Hossain has used satellites to reverse engineer the blueprint of dam operations on about 20 dams in the Mekong region, and his those findings to dozens of the planned dams to try to predict their likely water releases and storages, and how they may impact the surrounding landscape.

“Satellites are immune to political boundaries on the ground,” he said. “Information is key, and I think it should be a fundamental right for everyone to know what’s happening with the water around them, but that’s not the case here, unfortunately.”

In other aspects of the project, (civil and environmental engineering) will help forecast future floods under hydropower and climate change scenarios, while (public health) will integrate the fish and rice nutrient data with information on the nutritional needs of the local population.

In addition to lab and field work, the researchers plan to visit the region, documenting in video and photos the personal stories from people who live in the Mekong River basin. They will also involve 91±¬ÁĎ undergraduate students in a by accepting submissions for a based on stories from the Mekong.

The project will run for three years, and the researchers intend to share results along the way.

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For more information, contact Holtgrieve at gholt@uw.edu or 206-616-7041.