Neighborhood food environment, dietary fatty acid biomarkers, and cardiac arrest risk

The association between living environment and out-of-hospital cardiac arrest risk in adults: the perspective of daily-life contexts

BACKGROUND

Studying the spatial pattern of out-of-hospital cardiac arrest (OHCA) and its environmental impactors is crucial for both providing timely medical assistance and implementing preventative measures. Existing researches have mainly focused on natural and sociodemographic environments, usually at a macro- or meso-scale, while giving less attention to understanding the association between environment and OHCA risk from the perspective of daily-life contexts.

METHODS

In this study, we utilized 1843 eligible OHCA cases from core districts of Beijing in 2020 and employed modified Besag-York-Mollié (BYM2) Bayesian models to investigate the association between living environment (consisting of food environment, physical activity environment, healthcare environment and leisure environment) and adult OHCA risk, as well as its age disparities, at a 1 × 1 km2 cell resolution.

RESULTS

The results show that: (1) Fewer living environment factors are associated with the OHCA risk in the young/middle-aged group compared to the elderly group. (2) Unhealthy food destination like barbecue restaurants in living area is associated with increased OHCA risk in both age groups. (3) Facility inducing sedentary activity like chess rooms and healthcare facilities are associated with increased OHCA risk, but only among the elderly groups. (4) The decreased OHCA risk in the young/middle-aged group is related to public gathering places for socialization and relaxation in living area like coffee shops, while for the elder groups, decreased OHCA risk is associated with more green spaces in the living area.

CONCLUSIONS

The findings suggest that living environment may impact adult OHCA risk through shaping daily habits or providing access to health resources, with the underlying mechanism varying across different age groups. Future planning should fully consider and leverage the impact of living environment in order to effectively reduce OHCA risk.

The association of neighborhood walkability and food environment with incident cardiovascular disease in The Maastricht Study

Built environmental determinants can drive lifestyle behaviors and potentially reduce chronic disease prevalence. Few studies exist that have examined the association of obesogenic environment exposures with cardiovascular disease (CVD) outcomes. We aim to specifically examine the association between neighborhood walkability, food environment and CVD. Data from 6117 Dutch participants of The Maastricht Study, between the ages of 40 and 75 years in the Netherlands were examined. Home addresses were linked to geographic information systems data from the Geoscience and Health Cohort Consortium to create neighborhood exposures of walkability and food environment. Perceived walkability was obtained from the Abbreviated Neighborhood Environment Walkability Scale. An 11-year incidence of CVD was defined by self-reported non-fatal or fatal event (as registered by Statistics Netherlands). Cox regression models examined the association of environment exposures with incident CVD adjusted for demographic and socioeconomic variables. There was lower incidence of CVD using the perceived walkability questionnaire in those living in the most walkable neighborhood (Quartile 4 HR: .77; 95% CI = .62, .97) but not using the objective walkability index (Quartile 4 HR: 1.10; 95% CI = .89, 1.38). There was no association between the food environment and incident CVD (Quartile 4 HR: .82; 95% CI = .65, 1.04). The discordant findings between walkability measures suggest integrating residential feedback and accounting for lived experiences should be prioritized by policymakers when designing equitable neighborhoods to prevent CVD.

The association between food environments and cardiovascular disease outcomes: A systematic review

BACKGROUND

Cardiovascular disease (CVD) is the leading cause of death worldwide, particularly affecting low- and middle-income countries. Food environments may be linked with the risk of CVD; however, current study findings regarding their relationship are inconsistent. A systematic review of their associations is needed to guide interventions to improve cardiovascular health.

OBJECTIVE

This systematic review aimed to comprehensively assess the relationship between food environments and CVD outcomes, including incidence, hospitalization, mortality, and recurrence rates.

METHOD

According to PRISMA guidelines, a systematic search was conducted until 28th March 2024, using eight databases, including PubMed, Embase, Ovid, CINAHL, Web of Science, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data. The review quality was assessed according to the Agency for Healthcare Research and Quality (AHRQ) and Newcastle-Ottawa Scale (NOS). The included studies were categorized based on their exposure factors into unhealthy, healthy, and comprehensive food environments, encompassing facilities that offer healthy and unhealthy foods. The findings were narratively synthesized according to this classification.

RESULT

A total of 23 studies, encompassing 13 cross-sectional studies and 10 cohort-longitudinal studies, were included in this review. Among the 20 studies on unhealthy food environments, 13 found a positive association with CVD outcomes. Of the seven studies on healthy food environments, 3 found a negative association with CVD outcomes. Additionally, 4 out of 8 studies on comprehensive food environments found a significant but inconsistent association with CVD outcomes.

CONCLUSION

This study suggested that unhealthy food environments are probably associated with CVD outcomes. At the same time, there is currently no conclusive evidence to indicate a relationship between healthy food environments or comprehensive food environments and CVD outcomes.

Time-varying exposure to food retailers and cardiovascular disease hospitalization and mortality in the netherlands: a nationwide prospective cohort study

BACKGROUND

Very few studies to date investigated the prospective association of changes in exposure to the food environment with cardiovascular disease (CVD) risk. We aim to explore if time-varying exposure to the food environment was associated with hospitalization and mortality due to total and specific types of CVD in The Netherlands.

METHODS

In this prospective cohort study, 4,641,435 Dutch adults aged 35 + years who did not change residence in 2002-2018 were identified through registry data. Exposure to the food environment was defined as time-varying Food Environment Healthiness Index (FEHI) scores (range: - 5 to 5) and time-varying kernel density of specific food retailers (e.g., fast food outlets, supermarkets) around the home location between 2004 and 2018. The main outcome measures were hospitalization and mortality due to overall CVD, stroke, HF, and CHD occurring between 2004 and 2020, based on hospital and death registries.

RESULTS

In Cox regression models, each unit increase in the FEHI was associated with a lower hospitalization and mortality of CVD (hospitalization hazard ratio (HRh) = 0.90 (0.89 to 0.91), mortality hazard ratio (HRm) = 0.85 (0.82 to 0.89)), CHD (HRh = 0.88 (0.85 to 0.91), HRm = 0.80 (0.75 to 0.86)), stroke (HRh = 0.89 (0.84 to 0.93)), HRm = 0.89 (0.82 to 0.98)), and HF (HRh = 0.90 (0.84-0.96), HRm = 0.84 (0.76 to 0.92)). Increased density of local food shops, fast food outlets, supermarkets, and convenience stores and decreased density of food delivery outlets and restaurants were associated with a higher risk of CVD, CHD, stroke, and HF hospitalization and mortality.

CONCLUSIONS

In this observational longitudinal study, changes in exposure to a healthier food environment over 14 years were associated with a risk reduction in CVD hospitalization and mortality, in particular in urbanized areas and for younger adults and those with higher incomes.

Availability and Accessibility of Healthy and Unhealthy Foods in Neighborhood and their Association with Noncommunicable Diseases: A Scoping Review

ABSTRACT

Worldwide, 7 million mortalities and 187.7 million morbidities have been associated with dietary risks. Poor diets emerge because of an obesogenic environment. However, clear evidence indicating an association between food environment and noncommunicable diseases (NCDs) is inconclusive. The present review was conducted to study the associations between the availability/accessibility of healthy/unhealthy foods and the risk of NCDs among adults of the age group above 18. Studies published between 2012 and 2022 were reterived using three databases - PubMed, Google Scholar, and Science Direct. Following Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR), (2018) guidelines and based on the selection criteria, 3034 studies were retrieved, of which 64 were included in this review. Maximum studies were conducted in high-income countries and adopted a cross-sectional study design. Overall, the results of the review illustrate mixed findings. Compared to healthy food, direct associations between obesity and the availability/accessibility of unhealthy foods were reported (n = 12). In case of diabetes, supermarket availability was more likely to be protective (4 positive) compared to negative association with unhealthy food stores (3 associations in 11 studies). For cardiovascular diseases, an increased number of cases with fast-food outlets (n = 6) outnumbered positive associations with healthy food (n = 3). Studies concerning multiple NCDs reported direct association with unhealthy food outlets (n = 5) while inconclusive associations with healthy food. Despite a large number of studies, a weak, inconclusive relationship between food environment and NCDs was found. The use of standardized tools and longitudinal and interventional studies are warranted to rationalize the execution of the policies related to the food environment.

Associations between the neighbourhood food environment and cardiovascular disease: a systematic review

AIMS

To systematically review the current evidence on the association between the neighbourhood food environment and cardiovascular disease (CVD) in adults.

METHODS AND RESULTS

We searched the literature databases CINAHL, MEDLINE, and EMBASE for studies published between 1 January 2000 and 1 May 2022. Studies focusing on the indoor home, workplace, or school food environment were excluded. Two independent reviewers screened all records. Included studies were assessed for risk of bias using the shortened QUIPS tool, and relevant data were extracted. We summarized the findings using a narrative synthesis approach. We included 15 studies after screening 5915 original records. Most studies were published in the last 4 years and were predominantly conducted in North American or European countries. These studies focused on fast-food restaurant density in the residential neighbourhood. A higher fast-food restaurant density was most consistently associated with a higher prevalence and incidence of CVD and CVD mortality, but effect sizes were small. Evidence of an association between fast-food restaurant density and myocardial infarction, or stroke was inconsistent. The other aspects of the food environment were density of food service restaurants, unhealthy food outlets, and food access score. However, there was scant evidence for these aspects.

CONCLUSION

We found evidence for associations between the neighbourhood food environment and CVD, suggesting that a higher fast-food restaurant density is associated with CVD and CVD mortality. Effect sizes were small but important, given the fact that a large population is exposed. Research is needed to assess the effects of other aspects of the food environment.

SYSTEMATIC REVIEW REGISTRATION

PROSPERO CRD42022317407.

Twenty-five years of Health & Place: Citation classics, internationalism and interdisciplinarity

To mark 25 years of Health & Place Health & Place, we identify and appraise some key contributions to the journal over this period. We use citation data to identify 'classics' from the journal's back catalogue. We also examine trends in the international reach and disciplinary homes of our authors. We show that there has been a near 7-fold increase in the number of published papers between the early and most recent years of the journal and that the journal's citation levels are amongst the top 2% of social science journals. Amongst the most cited papers, some clear themes are evident such as physical activity, diet/food, obesity and topics relating to greenspace. The profile of the journal's authors is becoming more internationally diverse, represents a broader range of disciplines, and increasingly demonstrating cross/interdisciplinary ways of working. Although Anglophone countries have led the way, there is an increasing number of contributions from elsewhere including emerging economies such as China. We conclude with some comments on likely future directions for the journal including enduring concerns such as greenspace, obesity, diet and unhealthy commodities (alcohol, tobacco, ultra-processed food) as well as more recent directions including planetary health, longitudinal and lifecourse analyses, and the opportunities (and challenges) of big data and machine learning. Whatever the thematic concerns of the papers over next 25 years, we will continue to welcome outstanding research that is concerned with the importance place makes to health.

Activity space metrics not associated with sociodemographic variables, diet or health outcomes in the Seattle Obesity Study II

BACKGROUND

Activity spaces (AS), captured using GPS tracking devices, are measures of dynamic exposure to the built environment (BE).

METHODS

Seven days of Global Positioning Systems (GPS) tracking data were obtained for 433 adult participants in the Seattle Obesity Study (SOS II). Heights and weights were measured. Dietary intakes from a food frequency questionnaire were used to calculate Healthy Eating Index (HEI 2010) scores. Linear regression analyses examined associations between AS measures: daily route length, convex hull, and radius of gyration, and diet quality and health outcomes, adjusting for covariates.

RESULTS

AS measures did not vary by age, gender, race/ethnicity, or socioeconomic status. AS measures were not associated with diet quality or with self-reported obesity or diabetes. One AS measure, route length (in miles), was associated with being employed, living in the suburbs, and with distance and time commuting to work.

CONCLUSION

Spatial mobility studies based on GPS tracking of environmental exposure need to demonstrate a link to relevant health outcomes.