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

Citation

Kelman, Julie; Pool, Lindsay R.; Gordon-Larsen, Penny; Carr, John Jeffrey; Terry, James G.; Rana, Jamal S.; & Kershaw, Kiarri N. (2019). Associations of Unhealthy Food Environment with the Development of Coronary Artery Calcification: The CARDIA Study. Journal of the American Heart Association, 8(4), e010586. PMCID: PMC6405647

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.

URL

http://dx.doi.org/10.1161/jaha.118.010586

Reference Type

Journal Article

Year Published

2019

Journal Title

Journal of the American Heart Association

Author(s)

Kelman, Julie
Pool, Lindsay R.
Gordon-Larsen, Penny
Carr, John Jeffrey
Terry, James G.
Rana, Jamal S.
Kershaw, Kiarri N.

PMCID

PMC6405647

ORCiD

Gordon-Larsen - 0000-0001-5322-4188