To examine food concern (FC) and its associations with obesity and diabetes in a racially diverse, urban population.

Cross-sectional population-based survey.

Five boroughs of New York City.

Lower-income adults (n 5981) in the 2004 New York City Community Health Survey.

The overall prevalence of obesity was 24 % and was higher among FC than non-FC white men and women, black women, US- and foreign-born whites and foreign-born blacks. In multivariable analysis, FC was marginally associated with obesity (OR = 1·18, 95 % CI 0·98, 1·42) among all lower-income New Yorkers, after controlling for socio-economic factors. The association of FC and obesity varied by race/ethnicity, with FC being positively associated with obesity only among white New Yorkers. FC whites had 80 % higher odds of obesity than whites without FC (OR = 1·80; 95 % CI 1·21, 2·68), with a model-adjusted obesity prevalence of 20 % among non-FC whites v. 31 % among FC whites. FC was not associated with diabetes after controlling for obesity and socio-economic factors.

The prevalence of obesity was significantly higher among FC whites and certain subgroups of blacks. FC was positively associated with obesity risk among lower-income white New Yorkers. Programmes designed to alleviate FC and poverty should promote the purchase and consumption of nutritious, lower-energy foods to help address the burden of obesity in lower-income urban populations.