The relationship between the retail food environment and diet quality has received minimal investigation among weight loss maintainers. The aim of this study was to investigate the association between the residential retail food environment and diet quality in weight loss maintainers from WeightWatchers in the United States. Cross-sectional data were collected between January 2018 and February 2020. The Retail Food Environment Index (RFEI), based on geocoded home addresses, classified the environment as follows: RFEI <1.6 = healthiest; RFEI 1.6 to <2.5 = moderately healthy; RFEI 2.5 to <4.0 = moderately unhealthy; RFEI ≥4.0 = least healthy. Dietary data were obtained using a food frequency questionnaire. Adult participants (n = 1,159) who had lost weight using WeightWatchers and maintained ≥9.1-kg weight loss for ≥1 year (mean 24.7-kg loss for 3.4 years). Healthy Eating Index 2015 (HEI-2015) component and total scores (0-100; higher scores indicate better alignment with the 2015-2020 Dietary Guidelines for Americans). Regression models included RFEI category, the independent variable, and HEI-2015 and component scores (outcomes) controlling for age, sex, race and ethnicity, educational attainment, and household income. Compared with individuals living in the healthiest food environments (mean HEI-2015 score = 71.5) those in the unhealthiest environments had a mean HEI-2015 score of 70.1 (95% CI 68.8 to 71.3), those in moderately unhealthy environments had a score of 71.3 (95% CI 70.3 to 73.1) and those in moderately healthy environments had a score of 70.3 (95% CI 68.9 to 71.2), indicating a nonlinear relationship. Compared with those in the healthiest environments, those in the least healthy environments had an approximately 0.47 lower added sugar HEI-2015 component score (95% CI –0.86 to –0.08), indicating approximately 5% higher added sugar intake. Weight loss maintainers maintained high diet quality in diverse retail food environments. Compared with those in the healthiest food environments, those in the least healthy had a higher consumption of added sugars.

中文翻译：

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减肥维持者在多样化的住宅零售食品环境中维持高饮食质量

零售食品环境与饮食质量之间的关系在减肥维持者中受到的调查很少。本研究的目的是调查美国慧俪轻体 (WeightWatchers) 减肥维持者的住宅零售食品环境与饮食质量之间的关联。横截面数据是在 2018 年 1 月至 2020 年 2 月期间收集的。零售食品环境指数 (RFEI) 基于地理编码的家庭地址，将环境分类如下： RFEI <1.6 = 最健康； RFEI 1.6 至 <2.5 = 中等健康； RFEI 2.5 至 <4.0 = 中度不健康； RFEI ≥4.0 = 最不健康。使用食物频率问卷获得饮食数据。成年参与者 (n = 1,159) 使用慧俪轻体减肥并保持 ≥9.1 公斤体重减轻 ≥1 年（3.4 年平均减轻 24.7 公斤）。 2015 年健康饮食指数 (HEI-2015) 组成部分和总分（0-100；分数越高表明与 2015-2020 年美国人膳食指南的一致性越好）。回归模型包括 RFEI 类别、自变量、HEI-2015 以及控制年龄、性别、种族和民族、教育程度和家庭收入的成分分数（结果）。与生活在最健康食物环境中的个体（平均 HEI-2015 得分 = 71.5）相比，生活在最不健康环境中的个体的平均 HEI-2015 得分为 70.1（95% CI 68.8 至 71.3），那些生活在中度不健康环境中的个体的得分为71.3 分（95% CI 70.3 至 73.1），中等健康环境中的得分为 70.3（95% CI 68.9 至 71.2），表明存在非线性关系。与最健康环境中的人相比，最不健康环境中的人的添加糖 HEI-2015 成分得分低约 0.47（95% CI –0.86 至 –0.08），表明添加糖摄入量高出约 5%。减肥维持者在多样化的零售食品环境中保持高饮食质量。与那些生活在最健康食品环境中的人相比，那些生活在最不健康食品环境中的人摄入的添加糖含量更高。