About

Adam Drewnowski is a world-renowned leader in the study of obesity and social disparities in diets and health. He is a Professor of Epidemiology and the Director of the Center for Public Health Nutrition at the University of Washington School of Public Health. He also serves as the Director of the University of Washington Center for Obesity Research, which addresses the environmental, social, and economic aspects of the obesity epidemic. Dr. Drewnowski obtained his MA degree in biochemistry at Balliol College, Oxford, and a Ph.D. in psychology at The Rockefeller University in New York. Following post-doctoral training at the University of Toronto, he returned to The Rockefeller University as an Assistant Professor. He later moved to the University of Michigan, where he became Professor of Public Health, Psychology, and Psychiatry and Director of the Program in Human Nutrition at the School of Public Health. Since relocating to Seattle in 1998, he has contributed extensively to research on dietary patterns, nutrition economics, spatial distribution of obesity rates, and the development of metrics to identify nutrient-dense, affordable, and sustainable foods. Dr. Drewnowski is the inventor of the Nutrient Rich Foods Index and the Affordable Nutrition Index, and has conducted extensive studies on taste function, food preferences, and the genetics of bitter taste. His work also includes innovative spatial epidemiology of diets and health using GIS approaches. He has served on various national and international committees and has authored over 200 research papers, reviews, and book chapters.

Research topics

• Environmental health
• Medicine
• Food science
• Gerontology
• Computer Science
• Demography
• Internal medicine
• Economics
• Environmental science
• Biology
• Public economics
• Environmental engineering
• Physics
• Chemistry
• Biochemistry
• Engineering
• Mathematics
• Toxicology

Selected publications

• Consumption of 100% Juice and Diluted 100% Juice Is Associated with Better Compliance with Dietary Guidelines for Americans: Analyses of NHANES 2017–2023

  Nutrients · 2025-08-21 · 1 citations

  articleOpen accessSenior authorCorresponding

  Background: The Dietary Guidelines for Americans (DGA) and the American Academy of Pediatrics recommend limiting 100% juice consumption to 0.5–1.25 cups/day and to no more than one half of total fruit intake. Objective: To explore the dietary benefits of consuming 100% fruit juice and diluted 100% juice across diverse socio-demographic strata in the US. Methods: Consumption patterns for 100% juice and diluted 100% juice were examined by sex, age group, income-to-poverty ratio (IPR), and race/ethnicity. Dietary intakes came from the National Health and Nutrition Examination Survey (NHANES 2017–2020 and 2021–2023). The Healthy Eating Index 2020 (HEI 2020) and diet-level Nutrient Rich Food (NRF9.3) scores were the two measures of diet quality. The amounts of 100% juice consumed were compared to published DGA recommendations. Results: The consumption of 100% juice was greatly below that of water, milk, and sugar-sweetened beverages (SSBs). The consumption of diluted 100% juice was very low. Consumers of 100% juice had higher HEI 2020 scores (53 vs. 48) and diets with less added sugar and more total fruit, more potassium, calcium, and vitamin C. About 88% of the NHANES sample consumed <4 oz/day (1/2 cup) of 100% juice and most derived at least 50% of fruit from whole fruit, though some variation by income and race/ethnicity was observed. About 93% of the sample consumed <1 cup/day (8 oz) of 100% juice. Lower income groups consumed less whole fruit and more 100% juice. Conclusion: The consumption of 100% fruit juice was a marker of healthier dietary choices. The observed social gradient suggests that 100% fruit juice may provide valuable nutrients to populations who may be unable to afford or access whole fruit. Public health recommendations: The consumption of 100% fruit juice by some population subgroups could be increased. Fruit juice was not displacing whole fruit, and current consumption was well below the current DGA recommended values.

  PublisherOA PDFDOI

• Healthy Grains in Healthy Diets: The Contribution of Grain Foods to Diet Quality and Health in the National Health and Nutrition Examination Survey 2017–2023

  Nutrients · 2025-08-19 · 1 citations

  articleOpen access1st authorCorresponding

  Background: Grain foods are important sources of complex carbohydrates, fiber, vitamins, and minerals. Objective: To identify healthy grain foods and to assess their associations with composite diet quality measures and selected health outcomes. Methods: Healthy grain foods were identified using two methods. The first one, Carbohydrate Food Quality Score (CFQS-3) was based on whole grains, fiber, and added sugar. The second, NRF9.3g score for grains, balanced nutrients to encourage (protein, fiber, vitamins B1, B2, B3, and E, folate, iron, and magnesium) against added sugar, sodium, and saturated fat. Nutrient composition data for 1244 grain foods came from the USDA Food and Nutrient Database for Dietary Studies (FNDDS 2017–2023). Dietary intakes came from the National Health and Nutrition Examination Surveys (NHANES 2017–2023). The Healthy Eating Index (HEI 2020) and the diet-level Nutrient Rich Food Index (NRF) were the two measures of diet quality. National food prices came from the USDA 2021 Thrifty Food Plan. Data on body weight, waist circumference, insulin, and cholesterol came from NHANES clinical files. Results: Healthy grain foods were those that scored >2 points on CFQS-3 or were in the top tertile of NRF9.3g scores. The CFQS-3 score favored cooked whole grains and cereals and savory snacks. The NRF9.3g score gave the highest ratings to breads, rolls, and RTE cereals. Consumers of healthy grains identified using both methods had higher HEI 2020 values and higher diet-level NRF scores. Both effects were dose-dependent. Consumption of healthy grains was associated with lower obesity rates and lower fasting insulin levels. Conclusions: Consumption of healthy grain foods was associated with healthier diets and lower obesity prevalence. Dietary guidelines need to acknowledge the contribution of healthy grain foods to diet quality and health.

  PublisherOA PDFDOI

• Experiences and Perspectives of Racially Diverse Patients 5 Years Post-Bariatric Surgery: Qualitative Findings from the BELONG II Study

  Journal of Racial and Ethnic Health Disparities · 2025-10-16

  article
  PublisherDOI

• Development of Ferrero Nutrition Criteria: category-specific, progressive guidelines for product innovation

  Frontiers in Nutrition · 2025-07-14

  articleOpen access

  Background: Nutrition standards developed for internal use can help assess nutrient density and guide improvements in company product portfolios. Often category-specific, such standards are used to guide product innovation and new product development. Objective: To develop Ferrero Nutrition Criteria (FNC), a new set of progressive nutrition standards for internal use to evaluate product portfolio and to guide product formulation and development. Methods: The FNC was developed with reference to a publicly available database, the Food and Nutrient Database for Dietary Studies (FNDDS 2017-18) and the corresponding Food Pattern Equivalents Database (FPED), both maintained by the US Department of Agriculture. Nutrition standards were based on recommendations issued by international agencies and other expert bodies, pledges that regulate advertising and marketing to children, other existing nutrient profiling models, consumer trends, technological constraints, the nutritional composition of Ferrero products and their taste performance. Minimum values for nutrients and ingredients to encourage were based on dietary guidelines. Results: The FNC model was used to assign foods and beverages into three classes that were largely based on energy and on nutrients to limit (added sugar, saturated fat and sodium). Among nutrients to encourage were protein, fiber, vitamins, minerals and among ingredients to encourage were dairy, nuts, fruits, whole grains, legumes, seeds and vegetables. The setting of category specific criteria also took into account taste, portion size, eating occasions, and role of the food or beverage in the overall diet. The FNC model is intended to be progressive and to evolve continually as new products are developed. Conclusion: The FNC model reflects Ferrero's commitment to transparency and the promotion of responsible consumption. It will be used to guide improvements in the Ferrero product portfolio.

  PublisherOA PDFDOI

• Replacing Solid Snacks with Almonds or Adding Almonds to the Diet Improves Diet Quality and Compliance with the 2020–25 Dietary Guidelines for Americans: Modeling Analyses of NHANES 2017–23 Data

  Nutrients · 2025-12-26

  articleOpen accessSenior authorCorresponding

  Background: Healthier between-meal snacks can improve diet quality in the US and globally. Objectives: To assess the impact on diet quality of replacing solid snacks with almonds or adding almonds (30 g) to the diet. Methods: Dietary data for 4333 children (4–19 y) and 10,925 adults (>19 y) came from the National Health and Nutrition Examination Survey (NHANES 2017–23). Nutrient composition data came from the Food and Nutrient Databases for Dietary Studies (FNDDS). Substitution Model 1 replaced all solid snacks with almonds on a per-calorie basis. Model 2 exempted “healthy” snacks. Model 3 added almonds to the observed diet. The Healthy Eating Index (HEI-2020), Nutrient Rich Food Index (NRF), Mean Adequacy Ratio (MAR), and Mean Excess Ratio (MER) were measures of diet quality. Results: Solid snacks provided 329 kcal/day (15.6% of dietary energy), of which 58 kcal came from healthy snacks (2.9%). The 4–13 y age group consumed the most energy from snacks. Diets with almonds replacing solid snacks were lower in added sugar, sodium, and saturated (solid) fat but higher in protein, fiber, mono- and polyunsaturated fats, and magnesium. MAR dietary nutrient density scores were significantly higher, and MER scores were lower. Total HEI-2020 scores rose from 52.4 (observed) to 59.6 (Model 1) and to 60.6 in Model 2_100. The addition of almonds (30 g or 50 g) increased HEI-2020 values to 59.2 and to 61.4, respectively. Several HEI-2020 sub-scores increased as well. The greatest dietary benefits were obtained for children and young adults. Conclusions: Replacing solid snacks with small amounts of almonds led to higher quality modeled food patterns, especially for younger age groups. The DGA 2025–30 should address the inclusion of healthy energy-dense snacks into everyday diets.

  PublisherOA PDFDOI

• Distributed lag models for retrospective cohort data with application to a study of built environment and body weight

  Biometrics · 2025-01-07 · 1 citations

  articleOpen access

  Distributed lag models (DLMs) estimate the health effects of exposure over multiple time lags prior to the outcome and are widely used in time series studies. Applying DLMs to retrospective cohort studies is challenging due to inconsistent lengths of exposure history across participants, which is common when using electronic health record databases. A standard approach is to define subcohorts of individuals with some minimum exposure history, but this limits power and may amplify selection bias. We propose alternative full-cohort methods that use all available data while simultaneously enabling examination of the longest time lag estimable in the cohort. Through simulation studies, we find that restricting to a subcohort can lead to biased estimates of exposure effects due to confounding by correlated exposures at more distant lags. By contrast, full-cohort methods that incorporate multiple imputation of complete exposure histories can avoid this bias to efficiently estimate lagged and cumulative effects. Applying full-cohort DLMs to a study examining the association between residential density (a proxy for walkability) over 12 years and body weight, we find evidence of an immediate effect in the prior 1-2 years. We also observed an association at the maximal lag considered (12 years prior), which we posit reflects an earlier ($\ge$12 years) or incrementally increasing prior effect over time. DLMs can be efficiently incorporated within retrospective cohort studies to identify critical windows of exposure.

  PublisherOA PDFDOI

• Dietary Benefits of Pistachio Consumption in Mexico Modeled Using National Health Survey System (ENSANUT) 2012 and 2016 Data

  Nutrients · 2025-11-30

  articleOpen accessSenior authorCorresponding

  Background: Energy-dense non-essential snacks are subject to 8% excise tax in Mexico. Objectives: To model the impact on diet quality of (1) replacing energy-dense snacks with pistachios and (2) adding small amounts of pistachios to the diet. Methods: Data came from the Mexico National Health and Nutrition survey (ENSANUT, by its Spanish acronym) 2012 (n = 7132) and 2016 (n = 14,764). Dietary intakes were collected using a semi-quantitative food frequency questionnaire. Substitution analyses replaced energy-dense snack foods with equicaloric amounts of pistachios (Model 1) or with mixed nuts/seeds (Model 2). Additional analyses (Model 3) added small amounts of pistachios (10–28 g) to the daily diet. Added sugars, sodium, and saturated fat along with protein fiber, vitamins, and minerals were the main nutrients of interest. Dietary nutrient density was assessed using the Nutrient-Rich Food (NRF9.3) Index. Separate modeling analyses were performed for ENSANUT 2012 and 2016 and for children and adults. Results: Energy-dense foods, mostly sweet, accounted for about 20% of daily energy. Modeled diets with pistachios and mixed nuts/seeds were much lower in added sugars (<8% of dietary energy) and in sodium (<550 mg/day) and were higher in protein, fiber, mono- and polyunsaturated fats, potassium, and magnesium (p < 0.05). Significant improvements in dietary quality held across all socio-demographic strata. Adding small amounts of pistachios (10–28 g) to the diet (Model 3) increased calories but also led to better diets and higher NRF9.3 dietary nutrient density scores. Conclusions: Modeled diets with pistachios replacing energy-dense snack foods had less added sugars and sodium and more protein, fiber, vitamins, and minerals. Adding small amounts of pistachios also led to better diets. Pistachios are a healthy snack and can be an integral component of healthy diets.

  PublisherOA PDFDOI

• Influencers in Policy Fields on Social Media: Global Longitudinal Study of Dietary Sodium Reduction Posts, 2006-2022

  Journal of Medical Internet Research · 2024-12-30 · 1 citations

  articleOpen access

  BACKGROUND: Excessive sodium intake is a major concern for global public health. Despite multiple dietary guidelines, population sodium intakes are above recommended levels. Lack of health literacy could be one contributing issue and contemporary health literacy is largely shaped by social media. OBJECTIVE: This study aims to quantify the posting behaviors and influence patterns on dietary sodium-related content by influencers in the policy field on X (formerly Twitter) across time. METHODS: We first identified X users with a scope of work related to dietary sodium and retrieved their posts (formerly Tweets) from 2006 to 2022. Users were categorized into the policy groups of outer-setting organization, inner-setting organization, or individual, based on their role in the conceptual policy field. Network analysis was used to analyze interactions among users and identify the top influencers in each policy group. A 4D influence framework was applied to measure the overall influence, activity, priority, originality, and popularity scores. These measures were used to reveal the user-level, group-level, and temporal patterns of sodium-related influence. RESULTS: We identified 78 users with content related to dietary sodium, with 1,099,605 posts in total and 14,732 dietary sodium posts. There was an increasing volume of sodium posts from 2010 to 2015; however, the trend has been decreasing since 2016, especially among outer-setting organizations. The top influencers from the three policy groups were the World Health Organization (WHO), the American Heart Association, and Tom Frieden. Simon Capewell and the WHO ranked the highest in activity; the World Action on Salt, Sugar, and Health and Action on Salt had the highest priority for dietary sodium content; General Mills and Tom Frieden had the highest originality; and WHO, Harvard University School of Medicine, and Tom Frieden received the highest popularity. Outer-setting organizations tend to interact with more users in the network compared to inner-setting organizations and individuals, while inner-setting organizations tend to receive more engagements from other users in the network than the other two groups. Monthly patterns showed a significant peak in the number of sodium posts in March compared with other months. CONCLUSIONS: Despite the increased use of social media, recent trends of sodium intake education on social media are decreasing and the priority of sodium among other topics is low. To improve policy implementation effectiveness and meet recommended dietary targets, there is an increasing need for health leaders to consistently and collectively advocate for sodium intake reduction on social media.

  PublisherDOI

• Residential Density Is Associated With BMI Trajectories in Children and Adolescents: Findings From the Moving to Health Study

  AJPM Focus · 2024-03-15 · 7 citations

  articleOpen accessSenior author

  Introduction: This study investigates the associations between built environment features and 3-year BMI trajectories in children and adolescents. Methods: This retrospective cohort study utilized electronic health records of individuals aged 5-18 years living in King County, Washington, from 2005 to 2017. Built environment features such as residential density; counts of supermarkets, fast-food restaurants, and parks; and park area were measured using SmartMaps at 1,600-meter buffers. Linear mixed-effects models performed in 2022 tested whether built environment variables at baseline were associated with BMI change within age cohorts (5, 9, and 13 years), adjusting for sex, age, race/ethnicity, Medicaid, BMI, and residential property values (SES measure). Results: At 3-year follow-up, higher residential density was associated with lower BMI increase for girls across all age cohorts and for boys in age cohorts of 5 and 13 years but not for the age cohort of 9 years. Presence of fast food was associated with higher BMI increase for boys in the age cohort of 5 years and for girls in the age cohort of 9 years. There were no significant associations between BMI change and counts of parks, and park area was only significantly associated with BMI change among boys in the age cohort of 5 years. Conclusions: Higher residential density was associated with lower BMI increase in children and adolescents. The effect was small but may accumulate over the life course. Built environment factors have limited independent impact on 3-year BMI trajectories in children and adolescents.

  PublisherOA PDFDOI

• Dietary Flavonoid Intakes in France Are Linked to Brewed Tea Consumption and to Socioeconomic Status: Analyses of the Third French Individual and National Food Consumption (INCA3) Survey for Children and Adults

  Nutrients · 2024-04-10 · 2 citations

  articleOpen accessSenior authorCorresponding

  Flavonoids from green and black tea may benefit cardiovascular health. Brewed tea consumption and flavonoid intake in France have not been previously explored. This study assessed the dietary intake of flavonoids among French children and adults, using 3 days’ dietary recall for 3896 persons aged >4 y in the Third French Individual and National Food Consumption Survey (INCA3). Foods consumed by INCA 3 participants were manually matched with the flavonoid content of foods from the French PhenolExplorer database and the US Department of Agriculture expanded flavonoid database (2018 version). The six subclasses of flavonoids were flavan-3-ols, flavanones, anthocyanidins, flavonols, flavones, and isoflavones. Flavonoid intake was stratified by age subgroups (children and adults separately) and examined using socio-demographics and tea consumption patterns. Mean flavonoid intake was 210 mg/d. Flavonoids in the French diet were predominantly flavan-3-ols (147 mg/d), of which tea is the main source. The effects of age, education, income, and socio-professional category (SPC) on flavonoid intake were all significant (p < 0.0001). Brewed tea consumers were 31.88% of French adults and 3.79% of children. Brewed tea consumption and flavonoid intake were highly correlated. The highest brewed tea and flavonoid intakes were found among individuals with the highest SPC and education levels. Flavonoid intake in France was associated with brewed tea consumption and with higher education and income.

  PublisherOA PDFDOI

Recent grants

• Moving to Health: How changing built environments impact weight and glycemic control

  NIH · $582k · 2017–2022

• Food environment, diet quality and disparities in obesity

  NIH · $482k · 2007–2015

• Food environment, diet quality and disparities in obesity

  NIH · $642k · 2007–2015

• Food environment, diet quality and disparities in obesity

  NIH · $529k · 2007–2020

• NIH Grant R21DK085406

  NIH · $337k · 2013

Frequent coauthors

• Colin D. Rehm

  82 shared

• Nicole Darmon

  Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement

  80 shared

• Rishi Kansagra

  United Nations Children's Fund

  64 shared

• Dipika Matthias

  Bill & Melinda Gates Foundation

  64 shared

• Anura V. Kurpad

  St.John's Medical College Hospital

  64 shared

• Reynaldo Martorell

  Emory University

  64 shared

• Roland Kupka

  64 shared

• Venkatesh Mannar

  64 shared