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Food deserts increase risk for HF hospitalizations
Individuals with HF living in a food desert had increased risk for repeat all-cause and HF hospitalization, according to a study published in The American Journal of Cardiology.
“Subjects living in a [food desert] had increased systemic oxidative stress, inflammation and arterial stiffness, processes which are all predictive of increased risk of adverse outcomes in HF patients in other cohorts,” Alanna A. Morris, MD, MSc, assistant professor of medicine in the division of cardiology at Emory University School of Medicine, director of heart failure services at Atlanta VA Medical Center and a Cardiology Today’s Next Gen Innovator, and colleagues wrote.
Researchers analyzed data from 457 participants (mean age, 56 years; 40% women; 50% black) with prevalent HF with either preserved or reduced ejection fraction. The USDA Food Desert Research Atlas was used to determine whether participants lived in an an area with low access and low income.
Information collected at the baseline study visit included socioeconomic data, demographic data and clinical covariates. Data on clinical outcomes were collected at 6-month intervals.
The primary endpoint was repeat hospitalizations, specifically all-cause and HF hospitalizations.
Among the cohort, 106 lived in a food desert. Participants who lived in a food desert were more likely to be black (P < .0001), younger (P = .01), less likely to have commercial insurance (P = .003) and less educated (P = .003).
During a median follow-up of 827 days, 13.1% of participants died and 57.3% were hospitalized. There were no differences in risk for at least one all-cause hospitalization (60.4% vs. 56.4%; P = .5) and death (10.4% vs. 14%; P = .3) when participants who lived in food deserts were compared with those who did not live in those areas.
Participants who lived in a food desert had a higher overall frequency of all-cause hospitalizations compared with those who did not live in a food desert (94.1 per 100 patient-years vs. 63.6 per 100 patient-years). This was also seen for HF hospitalizations (59.6 per 100 patient-years vs. 30.5 per 100 patient years).
After adjusting for covariates, participants who lived in a food desert had increased risk for repeat HF hospitalizations (HR = 1.3; 95% CI, 1.02-1.65) and all-cause hospitalizations (HR = 1.21; 95% CI, 1.02-1.44).
“Because [food deserts] may negatively affect risk factors and health behaviors, more research is needed to determine how access to healthy foods influences the types of foods consumers purchase and eat, as well as other healthy behaviors,” Morris and colleagues wrote. “Although public health advocates would hope that increased access would also increase the intake of affordable and nutritious foods, studies have shown that consumers often continue to make unhealthy choices based on personal preferences even after healthier food options are more widely available.” – by Darlene Dobkowski
Disclosures: The authors report no relevant financial disclosures.