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Multicenter Study
. 2019 Feb 19;8(4):e010586.
doi: 10.1161/JAHA.118.010586.

Associations of Unhealthy Food Environment With the Development of Coronary Artery Calcification: The CARDIA Study

Julie Kelman  1 , Lindsay R Pool  1 , Penny Gordon-Larsen  2 , J Jeffrey Carr  3 , James G Terry  3 , Jamal S Rana  4 , Kiarri N Kershaw  1
Affiliations
Multicenter Study

Associations of Unhealthy Food Environment With the Development of Coronary Artery Calcification: The CARDIA Study

Julie Kelman et al. J Am Heart Assoc. .

Abstract

Background While prior studies have linked the neighborhood environment and development of subclinical atherosclerosis, it is unknown whether living in neighborhoods with greater availability of "unhealthy" food outlets (fast-food chain restaurants and convenience stores) is associated with risk of developing coronary artery calcification ( CAC ). Methods and Results We included 2706 CARDIA study (Coronary Artery Risk Development in Young Adults) participants who underwent CAC measurement during follow-up years 15 (2000-2001), 20 (2005-2006), and 25 (2010-2011). Neighborhood features examined included percentage of all food outlets that were convenience stores and fast-food chain restaurants within a 3-km Euclidean buffer distance from each participant's residence. Econometric fixed effects models, which by design control for all time-invariant covariates, were used to model the longitudinal association between simultaneous within-person change in percentage food outlet and change in CAC . At baseline (year 15), 9.7% of participants had prevalent CAC . During 10 years of follow-up, 21.1% of participants developed CAC . Each 1-SD increase in percentage of convenience stores was associated with a 1.34 higher odds of developing CAC (95% CI : 1.04, 1.72) after adjusting for individual- and neighborhood-level covariates; however, there was no significant association between increased percentage of fast-food chain restaurants and developing CAC (odds ratio=1.15; 95% CI : 0.96, 1.38). There were no significant associations between increases in either food outlet percentage and progression of CAC . Conclusions Our findings suggest that increases in the relative availability of convenience stores in participants' neighborhoods is related to the development of CAC over time.

Keywords: atherosclerosis; coronary artery calcification; neighborhood.

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Figures

Figure 1
Figure 1
Percentage of all food outlets that are convenience stores and fast‐food chain restaurants by year and outlet type.
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