Associations of Home and Time-Weighted Routine Activity Space Food Environments with Dietary Quality: Results from the Everyday Environments and Experiences (E3) Study

Despite considerable research on residential food environments and dietary behavior, evidence linking neighborhood food access to dietary intake remains inconclusive. Activity space approaches, which account for the full range of locations people routinely visit, may better capture real-world food environment exposures. Using data from the Everyday Environments and Experiences (E3) Study, a cross-sectional study of 328 racially and ethnically diverse midlife adults in Cook County, Illinois, we compared associations of time-weighted Global Positioning System-derived activity space and home food environment measures with diet quality. Food environment measures included distance to nearest convenience store, fast food chain restaurant, and supermarket. Dietary quality was assessed from multiple 24 h dietary recalls and operationalized using the Healthy Eating Index-2020. Shorter distances to food outlets in participants’ routine activity spaces, but not outlet density, were associated with better dietary quality after adjustment for sociodemographic characteristics (age, gender, race/ethnicity, income, education, and season). No statistically significant associations were observed for any home-based food environment measure, and relationships did not vary by sociodemographic characteristics. These findings highlight the value of activity space approaches for capturing food environment exposures that residential measures do not.