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Relations between the residential fast-food environment and the individual risk of cardiovascular diseases in The Netherlands: A nationwide follow-up study.

ABSTRACT: Background The food environment has been hypothesized to influence cardiovascular diseases such as hypertension and coronary heart disease. This study determines the relation between fast-food outlet density (FFD) and the individual risk for cardiovascular disease, among a nationwide Dutch sample. Methods After linkage of three national registers, a cohort of 2,472,004 adults (?35 years), free from cardiovascular disease at January 1st 2009 and living at the same address for ?15 years was constructed. Participants were followed for one year to determine incidence of cardiovascular disease, including coronary heart disease, stroke and heart failure. Street network-based buffers of 500?m, 1000?m and 3000?m around residential addresses were calculated, while FFD was determined using a retail outlet database. Logistic regression analyses were conducted. Models were stratified by degree of urbanization and adjusted for age, sex, ethnicity, marital status, comorbidity, neighbourhood-level income and population density. Results In urban areas, fully adjusted models indicated that the incidence of cardiovascular disease and coronary heart disease was significantly higher within 500?m buffers with one or more fast-food outlets as compared with areas with no fast-food outlets. An elevated FFD within 1000?m was associated with an significantly increased incidence of cardiovascular disease and coronary heart disease. Evidence was less pronounced for 3000?m buffers, or for stroke and heart-failure incidence. Conclusions Elevated FFD in the urban residential environment (?1000?m) was related to an increased incidence of cardiovascular heart disease and coronary heart disease. To better understand how FFD is associated with cardiovascular disease, future studies should account for a wider range of lifestyle and environmental confounders than was achieved in this study.

SUBMITTER: Poelman M

PROVIDER: S-EPMC6130123 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Relations between the residential fast-food environment and the individual risk of cardiovascular diseases in The Netherlands: A nationwide follow-up study.

Poelman Maartje M Strak Maciej M Schmitz Oliver O Hoek Gerard G Karssenberg Derek D Helbich Marco M Ntarladima Anna-Maria AM Bots Michiel M Brunekreef Bert B Grobbee Rick R Dijst Martin M Vaartjes Ilonca I

European journal of preventive cardiology 20180424 13

Background The food environment has been hypothesized to influence cardiovascular diseases such as hypertension and coronary heart disease. This study determines the relation between fast-food outlet density (FFD) and the individual risk for cardiovascular disease, among a nationwide Dutch sample. Methods After linkage of three national registers, a cohort of 2,472,004 adults (≥35 years), free from cardiovascular disease at January 1st 2009 and living at the same address for ≥15 years was constr ...[more]

PMID: 29688759

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Project description:BackgroundUnhealthy food environments may contribute to unhealthy diets and risk of overweight and obesity through increased consumption of fast-food. Therefore, we aimed to study the association of relative exposure to fast-food restaurants (FFR) with overall diet quality and risk of overweight and obesity in a sample of older adults.MethodsWe analyzed cross-sectional data of the EPIC-NL cohort (n = 8,231). Data on relative FFR exposure was obtained through linkage of home address in 2015 with a retail outlet database. We calculated relative exposure to FFR by dividing the densities of FFR in street-network buffers of 400, 1000, and 1500 m around the home of residence by the density of all food retailers in the corresponding buffer. We calculated scores on the Dutch Healthy Diet 2015 (DHD15) index using data from a validated food-frequency questionnaire. BMI was categorized into normal weight (BMI < 25), overweight (25 ≤ BMI < 30), and obesity (BMI ≥ 30). We used multivariable linear regression (DHD15-index) and multinomial logistic regression (weight status), using quartiles of relative FFR exposure as independent variable, adjusting for lifestyle and environmental characteristics.ResultsRelative FFR exposure was not significantly associated with DHD15-index scores in the 400, 1000, and 1500 m buffers (βQ4vsQ1= -0.21 [95 %CI: -1.12; 0.70]; βQ4vsQ1= -0.12 [95 %CI: -1.10; 0.87]; βQ4vsQ1 = 0.37 [95 %CI: -0.67; 1.42], respectively). Relative FFR exposure was also not related to overweight in consecutive buffers (ORQ4vsQ1=1.10 [95 %CI: 0.97; 1.25]; ORQ4vsQ1=0.97 [95 %CI: 0.84; 1.11]; ORQ4vsQ1= 1.04 [95 %CI: 0.90-1.20]); estimates for obesity were similar to those of overweight.ConclusionsA high proportion of FFR around the home of residence was not associated with diet quality or overweight and obesity in this large Dutch cohort of older adults. We conclude that although the food environment may be a determinant of food choice, this may not directly translate into effects on diet quality and weight status. Methodological improvements are warranted to provide more conclusive evidence.

Dataset Information

Relations between the residential fast-food environment and the individual risk of cardiovascular diseases in The Netherlands: A nationwide follow-up study.

Publications

Relations between the residential fast-food environment and the individual risk of cardiovascular diseases in The Netherlands: A nationwide follow-up study.

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