In a world where food production is at an all-time high, hypermarkets seem to be popping up in every industrial zone, and convenience stores are expanding market reach in cities and towns alike, it may be difficult to imagine that ‘food deserts’ exist.
But indeed they do, and millions around the Western world are affected.
A food desert is a term used to describe a neighbourhood with severely limited access to affordable fresh whole foods, such as fruit and vegetables.
According to 2018 data from non-profit think tank The Social Market Foundation, 10.2m people in the UK live in food deserts.
Distance and socioeconomic disadvantages are known to make food desert issues worse. Out of this staggering 10.2m people, 1.2m live in deprived areas.
‘Food desertification’ is also rife in the US, where according to 2009 data 23.5m people lack access to a supermarket within a mile of their home. Further, those in low-income areas are estimated to have access to 25% fewer grocery stores or supermarkets.
How do food deserts impact health?
Living in a food desert not only means limited access to healthy whole foods, it often means increased consumption of ultra-processed foods high in fat, salt, and sugar (HFSS).
Such products have been associated with obesity and non-communicable diseases, such as type 2 diabetes and coronary heart disease.
Fast food operators are a major distributor of HFSS products, yet are commonplace in neighbourhoods devoid of supermarkets.
A recent study published in BMJ Journals revealed that people who live in, or commute through, areas with a high density of fast food outlets are more likely to purchase takeaway food – with disastrous effects on health.
“Takeaway meal consumption are risk markers for coronary heart diseases, type 2 diabetes and obesity in children aged 9-10 years,” observed the study authors.
“More frequent takeaway meal consumption in children was associated with unhealthy dietary nutrient intake patterns and potentially with adverse longer-term consequences for obesity and coronary heart disease risk.”
Paying the ultimate price
And now, an Australian paper written by the University of Newcastle’s Tarunpreet Saluja has taken this research one step further to link accessibility to fast food restaurants with heart attacks.
The retrospective cohort study analysed data from 3,070 patients who suffered a heart attack between 2011 and 2013 in New South Wales’ Hunter Valley. By examining each patient’s postcode, researchers were able to identify their accessibility to fast food restaurants.
Alarmingly, the report, titled ‘Impact of Fast Food outlet Density on Incidence of Acute Myocardial Infarction in the Hunter Region’, found that for every additional fast food outlet identified by the researchers, there were four more heart attacks per 100,000 people each year.
“The findings were consistent across rural and metropolitan areas of New South Wales and after adjusting for age, obesity, high blood lipids, high blood pressure, smoking status, and diabetes, the results emphasise the importance of the food environment as a potential contributor towards health,” reported Saluja.
“Ischaemic heart disease, including heart attack, is one of the leading causes of death worldwide,” he continued. “It is known that eating fast foods is linked with a higher likelihood of fatal and nonfatal heart attacks.
“Despite this, there is rapid growth in the purchase and availability of fast food. This highlights the need to explore the role of food availability in the probability of having a heart attack.”
A call for policy change
With again those in deprived areas suffering the most, isn’t it time change is implemented at a regulatory level?
Responding to Saluja’s paper presented at this year’s scientific meeting of the cardiac society of Australia and New Zealand (CSANZ), scientific programme committee chair Tom Marwick said this ‘important paper’ will be crucial to explore whether the association between fast foods and cardiac events is independent of the social determinants of disease. “As we know that fast food outlets are more common in disadvantaged areas,” he continued.
“Nonetheless, the findings are a reminder that the fundamental drivers of cardiovascular disease burden may be altered by changes in public policy,” Marwick told delegates.
“The fact that the appropriate policy steps have not been taken, despite the cost of cardiovascular disease, remains as much a mystery in Australia as elsewhere in the world.”
Course director of the European Society of Cardiology (ESC) programme at CSANZ, Jeroen Bax, agreed increased regulation could play a part in tackling the food desert problem – alongside individual responsibility.
“Tackling heart disease requires individual responsibility and actions at population level. This study highlights the impacts of the food environment on health,” he said.
“In addition to regulating the location and density of fast food outlets, local areas should ensure good access to supermarkets with healthy food.”
Bax makes a good point. Regulating the fast food environment won't solve food desertification without also taking grocery location into account.
So as obesity and noncommunicable diseases continue to dominate the health sector, let's ensure a multisectoral approach to food desertification, covering foodservice and supermarket retail, is part of the story.
Source: BMJ Journals
‘Takeaway meal consumption and risk markers for coronary heart disease, type 2 diabetes and obesity in children aged 9-10 years: a cross-sectional study’
DOI: http://dx.doi.org/10.1136/archdischild-2017-312981
Authors: Angela S Donin, Claire M Nightingale, Chris G Owen, Alicja R Rudnicka, Derek G Cook, Peter H Whincup