Living near pubs, fast-food restaurants and bars could harm heart health : Study

Proximity to Unhealthy Food Environments Linked to Increased Risk of Heart Failure, Study Finds
Living close to pubs, bars, and fast-food restaurants may pose a higher risk of heart failure, according to recent research published in Circulation: Heart Failure, an American Heart Association journal. The study, led by senior author Dr. Lu Qi, a professor in the epidemiology department at Tulane University in New Orleans, sheds light on the association between the food environment and heart failure through long-term observation.

Heart failure, a condition in which the heart struggles to pump enough blood to fulfill the body’s needs, has been historically linked to various factors, including lifestyle and dietary choices. However, previous studies have primarily focused on food quality, neglecting the impact of the food environment. Drawing data from the UK Biobank, this recent research marks one of the first attempts to explore the relationship between heart failure and the surrounding food environment.

The researchers analyzed the UK Biobank data, a comprehensive database encompassing health information for over 500,000 adults in the United Kingdom. The study examined participants’ exposure to three types of food environments: pubs or bars, restaurants or cafeterias, and fast-food outlets. Exposure was determined by both proximity (living within 1 kilometer or a 15-minute walk) and density (the number of ready-to-eat food outlets within the predefined 1-kilometer radius).

Heart Health and Living Near Pubs.

Over the 12-year follow-up period, during which nearly 13,000 heart failure cases were documented, the analysis pointed to a significant correlation between the density and proximity of ready-to-eat food outlets and an elevated risk of heart failure. Key findings include:

1. Overall Risk Increase: Participants residing in areas with the highest density of ready-to-eat food outlets (11 or more within a 1-kilometer radius) faced a 16% greater risk of heart failure than those without such outlets near their homes.

2. Specific Environment Risks: Individuals living in areas with high densities of pubs and bars experienced a 14% higher risk. In comparison, those in fast-food-dense regions had a 12% higher risk of heart failure.

3. Proximity Effects: Those living closest to pubs and bars (within 500 meters) had a 13% higher risk, and those closest to fast-food outlets had a 10% higher risk than those living farther away (more than 2,000 meters).

4. Socioeconomic Disparities: Heart failure risk was more pronounced among participants without a college degree and adults in urban areas lacking access to formal physical activity facilities like gyms.

Dr. Lu Qi highlighted the significance of considering the food environment in nutrition research, emphasizing that the study’s findings align with prior research linking ready-to-eat food environments to other health issues like Type 2 diabetes and obesity. The results suggest that enhancing access to healthier food options and physical fitness facilities, particularly in urban areas, could mitigate the increased risk of heart failure associated with quick-meal options.

An accompanying editorial by Dr. Elissa Driggin and Dr. Ersilia M. DeFilippis from Columbia University Medical Center in New York stresses the need for more detailed analyses in communities with diverse populations, especially considering the known associations between Black race and higher incidence of heart failure. They urge attention to food environments in high-risk populations and emphasize the existing disparities in access to supermarkets between predominantly Black and white neighborhoods.

The American Heart Association, recognizing the importance of food environments in health outcomes, is actively working on initiatives such as the Health Care by Food TM initiative. This initiative aims to invest in research, advocacy, and education to demonstrate the clinical benefits and cost-effectiveness of interventions using food as medicine, with the goal of having these interventions covered by public and private health insurance.

The Association’s 2023 Presidential Advisory highlighted the challenges of the current food system, emphasizing the need for a systemic focus on improving food environments and ensuring the healthfulness of local food systems. Structural issues such as systemic racism and poverty contribute to poor-quality diets, disproportionately affecting historically excluded populations.

In conclusion, the study points to the importance of addressing food environments to prevent heart failure. While the research provides valuable insights, it acknowledges certain limitations, such as potential exposure misclassification and the absence of nutrition insecurity data. The study’s observational nature prevents establishing causality, emphasizing the need for further research to enhance the robustness and applicability of these findings.

Moving forward, efforts to improve access to healthier food environments, especially in urban areas, coupled with initiatives promoting physical fitness and education, could significantly reduce the risk of heart failure associated with consuming readily available, unhealthy foods.