The Relationship Between the Supply of Fast-food Chains and Cardiovascular Outcomes

Abstract

Objective: To examine the extent to which inter-regional differences in fast-food concentrations account for variations in all-cause mortality and acute coronary syndromes throughout Ontario, Canada.Methods: Nine distinct fast-food chains were selected based on top sales data in 2001. The per capita rate of fast-food outlets per region was calculated for each of 380 regions throughout Ontario. Outcome measures, obtained using 2001 vital statistics data and hospital discharge abstracts, included regional per capita mortality rates and acute coronary syndrome hospitalization rates; head trauma served as a comparator. All regional outcomes were adjusted for age, gender, and socio-economic status, and were analyzed as continuous and rank-ordered variables as compared with the provincial average.Results: Mortality and admissions for acute coronary syndromes were higher in regions with greater numbers of fast-food services after adjustment for risk. Risk-adjusted outcomes among regions intensive in fast-food services were more likely to be high outliers for both mortality (Adjusted Odds Ratio (OR): 2.52, 95% confidence intervals (CI): 1.54-4.13, p<0.001) and acute coronary hospitalizations (Adjusted OR: 2.62, 95% CI 1.42-3.59, p<0.001) compared to regions with low fast-food service intensity. There was no relationship between the concentration of fast-food outlets and risk-adjusted head-trauma hospitalization rates.Interpretation: Inter-regional cardiac outcome disparities throughout Ontario were partially explained by fast-food service intensity. Such findings emphasize the need to target health promotion and prevention initiatives to highest-risk communities.MeSH terms: Coronary disease; human; risk; food supply; restaurants; mortality La traduction du résumé se trouve à la fin de l'article.

Geographic Determinants of Healthy Lifestyle Change in a Community-Based Exercise Prescription Delivered in Family Practice

“…The positive effect in our study of proximity to some but not all physical activity facilities on health predictors such as BMI has been described19 and could reflect a preference for certain activities including golf or tennis over lawn bowling or swimming reflected as choices of place of residence in the study population. The HSA cohort in our study has been previously described31 as having a more heterogeneous place of residence than the CRF group reflecting choices (or not) in supporting a healthy lifestyle.…”

Obesity prevalence and the local food environment

“…Because few published studies have linked the disparities in the types of food stores and restaurants with health outcomes, this study aimed to measure the association between neighborhood availability of food stores and cardiovascular health among adults living in the southern region of the United States. Because of these findings from other investigators (Inagami et al, 2006; Morland et al, 2006; Alter and Eny, 2005; Maddock, 2004; Sturm and Datar, 2005), we hypothesized that a higher prevalence of supermarket and a lower prevalence of small grocery stores and fast food restaurants would be associated with a lower prevalence of obesity among adult residents. Moreover, we hypothesized that those individuals living closer to supermarkets, as well as those living further from small grocery stores and fast food restaurants, would have lower BMIs.…”

“…Authors found that adults living in areas with supermarkets had a lower prevalence of obesity compared to adults who lived in census tracts with no supermarkets. Alter and Eny (2005) found the density of fast food restaurants to be associated with cardiovascular events in Canada. In the United States, Maddock (2004) used state-level data to demonstrate a correlation between the density of fast food restaurants and state-level obesity prevalence.…”

Dynamic relations between fast-food restaurant and body weight status: a longitudinal and multilevel analysis of Chinese adults

“…14 Moreover, contrary to expectations, this study found an elevated risk of being overweight among individuals living farther away from multinational fast-food outlets as compared with those living closer. A Canadian study reported a positive association of regional fast-food concentration with rates of acute coronary hospitalisation in Ontario, 15 whereas a Swedish study found no significant association between community availability of fast-food restaurants and individual-level coronary heart disease risk. 16 Therefore, findings from the USA and other high-income countries are inconsistent and unlikely to be generalisable to other settings where obesity is on the rise.…”