Association of Fast‐Food and Full‐Service Restaurant Densities With Mortality From Cardiovascular Disease and Stroke, and the Prevalence of Diabetes Mellitus

Abstract

BackgroundWe explored whether higher densities of fast‐food restaurants (FFRs) and full‐service restaurants are associated with mortality from cardiovascular disease (CVD) and stroke and the prevalence of type 2 diabetes mellitus (T2D) across the mainland United States.Methods and ResultsIn this cross‐sectional study county‐level data for CVD and stroke mortality, and prevalence of T2D, were combined with per capita densities of FFRs and full‐service restaurants and analyzed using regression. Mortality and diabetes mellitus prevalence were corrected for poverty, ethnicity, education, physical inactivity, and smoking. After adjustment, FFR density was positively associated with CVD (β=1.104, R 2=2.3%), stroke (β=0.841, R 2=1.4%), and T2D (β=0.578, R 2=0.6%) and full‐service restaurant density was positively associated with CVD mortality (β=0.19, R 2=0.1%) and negatively related to T2D prevalence (β=−0.25, R 2=0.3%). In a multiple regression analysis (FFRs and full‐service restaurants together in same model), only the densities of FFRs were significant (and positive). If we assume these relationships are causal, an impact analysis suggested that opening 10 new FFRs in a county would lead to 1 extra death from CVD every 42 years and 1 extra death from stroke every 55 years. Repeated nationally across all counties, that would be an extra 748 CVD deaths and 567 stroke deaths (and 390 new cases of T2D) over the next 10 years.ConclusionsThese results suggest that an increased density of FFRs is associated with increased risk of death from CVD and stroke and increased T2D prevalence, but the maximal impact (assuming the correlations reflect causality) of each individual FFR is small.Clinical Trial RegistrationURL: http://www.clinicaltrials.gov. Unique identifier: NCT03243253.

Objectively Measured Built Environments and Cardiovascular Diseases in Middle-Aged and Older Korean Adults

“…A study of more than four million Swedes between 35 and 80 years of age reported a statistically significant association between fast-food restaurants and stroke, although the ORs of the association were not large [ 12 ]. In addition, a study from the United States showed a significantly positive association between fast-food restaurants and mortalities related to CVD and stroke [ 30 ]. However, a longitudinal study from Australia found no association between the food environment and hypertension [ 28 ].…”

Fast food consumption among young adolescents aged 12–15 years in 54 low- and middle-income countries

“…Failure to meet nutrient requirements during adolescence can result in growth retardation, impaired organ remodeling, and micronutrient deficiencies [6]. Such unhealthy dietary habits in youth are thus associated with an increased risk of obesity [7], cardiovascular disease [8], type 2 diabetes [9], and cancer [10] in later adulthood.…”

Knowledge and Attitude of Medical Students at the Universitas Sumatera Utara toward Lifestyle that Contributes to Type 2 Diabetes

“…For example, the wrong diet, overeating, eating fast foods regularly, and tends to choose eating sweet foods are the risk factor for type 2 diabetes because it can cause obesity. Obesity is one of the main predisposing factors for metabolic disorders, such as insulin resistance in type 2 diabetes [7]. Lack of physical activity is also contributed to type 2 diabetes.…”