There is a growing literature that evaluates the links between the food environment and dietary intake and health outcomes. Findings are highly contingent on constructed measures of the food environment, which vary substantially across studies. Furthermore, different measures assume different underlying relationships between the food environment and individual outcomes. 

This study proposes an alternative measure to the Retail Food Environment Index (RFEI), called the "Physical Food Environment Indicator" (PFEI), and tests its association with adult body mass index (BMI) and obesity in California.​ The development of measures to date has focused on two dimensions: the geographic definition of the food environment, and the variety of food outlet types available in the neighbourhood. The predictive value of PFEI has been analysed at two levels: county and census tract.

This study relied on secondary data from California Health Interview Survey.