The study, which appears in the latest edition of Circulation, found evidence for promoting greater access healthy food resources in neighbourhoods as a way of slowing down the onset of atherosclerosis.
The condition causes the hardening of the arteries and underlies many types of heart disease. Diets high in fruits, vegetables, antioxidants, whole grains and fish have been shown to reduce progression of heart disease in observational studies.
From a clinical perspective, the results give added weight to increasing neighbourhood resources in which healthy food is sold at an affordable price.
A number of studies have looked into neighbourhood deprivation and its link to atherosclerosis. However, determining which neighbourhood factors were driving the association has proved tricky.
The team, from Grand Valley State University in Michigan, began by enrolling 5,950 adults taken from the Multi-Ethnic Study of Atherosclerosis (MESA) over a 12 year follow-up period. These subjects were aged 45–84 years and free of clinical cardiovascular disease.
Disease progression was measured via coronary artery calcium (CAC), a scoring system that has been shown to independently predict coronary events in diverse ethnic groups. Chest computed tomography (CT) was also used to provide a visual representation.
The subjects underwent a CT scan at the start of the study. Of the MESA subjects studied, 86% had CAC readings at three different times over the 12 years, with an average of 3.5 years between each measurement.
“Our research focused on having access to a wide range of foods that provide individuals the ability to choose what they eat rather than being limited to highly processed, high calorie foods with little to no nutritional value,” said Dr Ella August, co-lead author and clinical assistant professor of epidemiology at the University of Michigan.
“We found that healthy food stores within one mile of their home was the only significant factor that reduced or slowed the progression of calcium build up in coronary arteries,” she added.
Although studies have linked neighbourhood characteristics to coronary heart disease incidence and mortality there has been no notable research that has looked into changes in neighbourhood factors and how they affect the progression of atherosclerosis.
“Eating behaviour is shaped by many complex factors, both personal and environmental but in order for people to eat a healthy diet, they must have access to these foods,” added August.
The study also hypothesised that a favourable social environment would improve stress and depressive symptoms, favourably impacting CAC.
An improvement in the walking environment may also be related to reduced progression of this disease, the researchers thought, pointing to changes in walking environments and in BMI over time.
“Studies with improved measurement of the social and walking environments are needed to draw firmer conclusions regarding the possible effects of these domains on changes in subclinical disease,” the report concluded.
Published online ahead of print, DOI: 10.1161/CIRCULATIONAHA.115.020534
“Change in Neighborhood Characteristics and Change in Coronary Artery Calcium: A Longitudinal Investigation in the MESA (Multi-Ethnic Study of Atherosclerosis) Cohort.”
Authors: Jeffrey Wing, Ella August et al.